daily testing of pacemaker

Yes

by John_Locke - 2023-08-23 03:44:51

I believe that we have the same device and yes, I have and feel this too. I had mine changed from doing the test every 8 hours to once every 24 hours but 4.06 PM it does its thing. If I'm busy with other things, working, physically active, then I don't notice it but if I happen to be resting and still at the time then I can feel both the testing of the atrial pacing followed by ventricular pacing.

Often for me this is followed by ventricular pacing shortly after, presumably as my heart gets a bit confused by the forced pacing.

Same old drum

by piglet22 - 2023-08-23 07:11:59

Sorry to bang on about this, but John_Locke you must have a better team than mine.

Not once have they told me how any self-tests are performed or even if it happens at all.

If it wasn't for this forum, I wouldn't know much at all about my condition.

Why don't I ask you might say. You have to have an inkling of what's what before you can ask.

I Have The Same Make and Model

by Marybird - 2023-08-23 10:20:23

That's the St. Jude Assurity PM 2272. I don't recall anyone informing me of those self-checks either, makes me wonder if perhaps providers don't think about doing so unless patients ask them about the wierd flutters they may feel when the tests occur. I have short ( usually) intervals of SVT and Afib anyway, so I always assumed those test "flutters" were just another tachy run courtesy of my heart. I learned differently about two years ago during an in-clinic interrogation about those test modes. I mentioned to the tech that I had had a short episode of tachywhatever that morning, she looked and said it wasn't showing on the interrogation report. She explained those test runs, and turned that off on my pacemaker, saying I didn't need it. So I guess now any flutters I get now are coming from me, not the pacemaker. 

Pacemaker tested

by AgentX86 - 2023-08-23 11:21:14

It's not the pacemaker being tested, rather the heart.  The pacing and sensing margins are being tested and adjusted. This is the first time I've heard it being done every three hours.  It's normall done at night when you're sleeping to minimize the annoyance (unless it constantly wake the person up).  This isn't unique to Sj. Jude devices.  Medtronic also does this, though I dount that many have this feature turned on.

Mine was turned off because my EP thought it more of a problem than it was worth.  They just set the pacing margin to 100% and forget it between on-site interrogations. It could be because I have Vpace-100%, could only have a V-sense on a PVC, with an A-sense or pace impossible. The test could only test the V-pace margin, which would be of little to no value.

A.Cap Confirm & Ventricular Autocapture

by Penguin - 2023-08-23 15:43:02

See the link below. 

https://www.cardiocases.com/en/pacingdefibrillation/specificities/pm-pacing-sensing/abbott/pacing-sensing-abbott-pacemakers

A.Cap Confirm & Ventricular Autocapture are explained in the link. I think that these are the settings responsible for what you are feeling. :

Settings: 

ACap Confirm® is programmable to three modes: On, Monitor, Off

On: periodical threshold search, indexed data and amplitude adjustment

Monitor: periodical threshold search, indexed data but no amplitude adjustment

Off: no threshold search, no amplitude adjustment

Search interval: 8h, 24h

'Ventricular Autocapture®

automatic verification of capture beat-to-beat: the device looks for loss of capture on every beat

automatic back-up stimulation 5 V (unipolar or bipolar): if loss of capture is present, the device delivers a high output back-up pulse to ensure capture

automatic threshold search 8 or 24 hours: the device measures periodically (every 8 or 24 hours) the pacing threshold

automatic amplitude adjustment 0.25 V working margin: the device sets automatically the parameter Pulse Amplitude above the measured threshold with a non programmable working margin of 0.25 V

automatic fusion avoidance'

AutoCapture® works whatever the programmed Pulse Width is

Wasn't told until I asked

by John_Locke - 2023-08-23 18:36:30

I also had no information up front about this, I only knew about these tests from this forum and then a deep dive into the manual for the pacemaker. When I was in for a check up though and asked about it they were happy to tweak the settings.

It seems that the clock resets when they make changes so whatever the time of day was when the check up happened, that's how the time it will do the test, so for me 4:06 PM.

clock changes

by AgentX86 - 2023-08-24 00:08:19

That's wierd. I have the clock set for rate change for sleep.  It never changes unless I request a change.

Manual

by Penguin - 2023-08-24 13:20:30

I'm amazed that you were provided with a manual.

Manuals

by Marybird - 2023-08-24 13:51:26

Penguin, I don't think doctors/clinics give patients the technical manuals for cardiac or monitoring devices. But these can be found on the manufacturer's websites and can be downloaded if you wish to do so. 

These manuals show the specifications, including preparation and setting up the devices prior to, and during implantation, directions for setting parameters and interrogation. Some of the manuals show this information for more than one make and model of device, so it can be confusing to wade through all that to find yours- at least it was for me. Maybe this is just me, but I found thatmaybe 95% of the material in those manuals was way above my pay grade, but I got tidbits of information from the manuals that I think helped me understand a little bit about how my pacemaker works. 

Found manual though here

by John_Locke - 2023-08-25 18:54:04

Penguin, again I'm afraid it wasn't that easy. There's a thread here on the site where I ask for links to the technical manuals for my specific model. It's quite dense reading but you can find the specifics of thee things like self tests thresholds, modes etc if you go and look.