Feel sick on slightly bumpy road

I would ask about Rate Response

by Gemita - 2024-04-23 05:53:53

Hello Rob, Welcome.  Perhaps you have misunderstood the comment from your specialist (?cardiologist/electrophysiologist) about there only being two settings.  Perhaps he meant there are only two settings that could be adjusted to help with your symptoms?  There will certainly be more settings than two on your Medtronic W2DR01 pacemaker that your specialist can adjust if you carefully describe your symptoms.

It sounds as though you have the setting Rate Response (RR) turned on and might be getting vibrations and tachy events when you go over bumpy surfaces and this is likely stimulating your pacemaker and causing symptoms.  Your comments:

“Some research suggests it can be programmed better, providing there is a way to program the Low, Medium and High acitivity levels . . . “ 

suggest you have already been reading about this?  If your symptoms are due to the Rate Response setting being set too sensitively, you could ask for an exercise test on a treadmill to adjust these.  That seems to be the quickest way according to many members here, to get the best settings for each one of us, otherwise you may need to go back many times and it will be largely trial and error until they adjust them to suit you personally.  

Other than RR, when we have a new device, the lead voltage is usually set slightly higher until the lead tips are firmly embedded into heart tissue.  At our first main device check (say at 3 months) they lower the voltage.  I had vibratory symptoms from an initial high lead voltage setting and was uncomfortable, so you could ask about this setting.

Also, pacemakers can be programmed to pace and to sense in a bipolar mode (lead tip to lead ring) or a unipolar mode (lead tip to pulse generator). Bipolar sensing is preferred and mostly used which minimizes over-sensing and also minimizes pectoral muscle stimulation which some of us suffer from with unipolar pacing.  You could ask them to confirm that you are sensing and pacing in Bipolar mode?

I am a little confused because your post is telling me that you have a dual chamber Medtronic pacemaker (from the DR in the Model details) but you are saying you have only had the atrial lead in your pacemaker for a week?   Have you just had a pacemaker upgrade to a dual chamber from perhaps a single lead ventricular pacemaker?  It would be helpful to know why you have a pacemaker?

Bumpy roads

by Daedalus - 2024-04-23 10:16:18

I'm driving a small rental car on vacation and as we go over ruts, potholes, bumps, etc., I can feel my pacemaker accelerating my heart rate as it's assuming I'm perhaps jogging or exercising and the rate control is compensating.   Not very comfortable, but knowing that's what it is in my case, it's ok. I've found that leaning my upper body forward and away from the seat back (thus reducing vibrations to the chest) things get better.  
As Gemita points out, maybe this is similar to your situation.   

W2DR01 Pacemaker

by AgentX86 - 2024-04-23 15:34:46

No, there is not an "old farts" mode. and there a hell of a lot more than two settings.  I was going to count them but my eyes glazed over.  Here is the technical manual on that pacemaker.  The relevant information starts at about page 27, or Chapter 5 (the index on the side is clickable). You can also search for "Table 20".

BTW, Medtronic publishes all of their manuals online. Search for "Medtronic <model number> technical manual" to find the technical reference manual for yours.

Lol!

by Lavender - 2024-04-23 19:39:20

A setting for old people?? Nah!! Only two settings??  You need a new doctor who has more knowledge. 🫣🤭

Bad roads

by Gotrhythm - 2024-04-25 15:59:35

Like others I suspect the culprit is the RR (accellerometer)  feature, that speeds up your heartrate when you become more active. The thing is, it's not really sensing activity, it's sensing the vibration caused by activity. It's just a stupid machine so it can't tell if the vibration is caused by your doing jumping jacks or you are sitting still in a car that is traveling over potholes.

It will definitely make you feel uncomfortable, but recognizing it for what it is, and knowing as soon as the rode smoothes out, it will go away, helps.

I've also experienced it on planes when there was a lot of turbulence, and once, at a pipe organ concert when there was a lot of pedal. I think the wooden pews we were seated on transmitted the vibrations.

Overall, taking the bad with the good (or the rough with the smooth) I would rather have my pacemaker set so that my pacemaker would respond quickly when I need or want to move fast, than set so that I wouldn't be bothered by the occasional bumpy road.

But that's just me. People vary greatly in which and what kind of sensations they find tolerable or enjoyable. It's all about what works for you.

As for one setting for old people and one for everyone else, that's a bunch of manure! I have a St.Jude. It has five basic speeds. Mine was recently changed from very fast (the top speed) to fast. I'm 81.

Thanks everyone for your comments

by Stingraynut - 2024-04-28 03:57:38

Thanks everyone for the helpful comments, To fill in the background, I was diagnosed with slow heart rate SSS. I had the pacemaker fitted on 13th feb but the heart specialist who is supposed to be one of the best here, accidentally dislodged the Atrial lead after he had inserted it, he then accidentally punctured an artery. The artery swelled up and he was unable to replace the Atrial lead and while trying to do that he punctured a lung, which left me for 2 months with just the R Ventricle lead. 
2 days after surgery I went for a walk, it's hilly here and within 20 meters I had a severe pacemaker syndrome reaction. It was really bad, I had no option but to stand still and wait for it to pass. After a few of these I learned to walk like a burglar creeping around at night so that I didn't set it off. The specialist saw me the following week and the pacemaker tech turned the sensing down to below 50bpm.
I did of course call the specialist the moment I had the severe pacemaker syndrome events and his advice was 'to breathe more slowly and I'd get used to it'
He is considered one of the best here and medicos show surprise when I describe the above.

He managed to fit the Atrial lead on 16th April. After both surgeries and in the car visiting him a week later the pacemaker was set off by the bumpy road. He also used a longer lead than necessary and he tucked the excess lead beind the pacemaker, making it protrude from my chest. For a $20,000 operation I did not get my money's worth!

I explained about it being set off in the car and after some discussion where he said I was over sensitive (I Raced cars motorbikes and yachts all my life, but perhaps that's a medical term they use when they don't have an answer) he had the tech make some adjustments. The max is now 110 which is not perfect for walking back uphill but a lot better than before I had a pacemaker when I had to stop every 10 meters and wait. So I want the pacemaker to sense when I'm walking but not when in the car.

Lastly, I had the tech turn the pacemaker to 70bpm and then over several minutes she increased the heart rate. At 100 I began to feel pressure in the throat, at 110 there was more pressure and I wouldn't want any more than that, it was uncomfortable, at 120 I had the full feeling of pressure in my neck and chest and strong nausea. I sailed all my life and was never seasick. I suspect that feeling is doing some damage because I didn't feel well for several hours after.

Gemita thanks, the tech has mentioned I'm on 3.5volts and it will be turned down to 1.5v next visit in June. I'll ask about Bipolar and Unipolar. The Tech is a clever lady who was a Nurse for 20 years but probably only had a 2 or 3 day course on the pacemaker. I asked her if Medtronic had any advice on the best setttings to correct bumpy road sensing and she said no.

Daedalus I'll try the leaning forward, I noticed that my body was moving left and right as well and this was on the main road out of town. On a bumpy side road it went ballistic with chest pressure & strong nausea. 

AgentX86 Yes I had already tried to find the manual a few times. I have the specs listing all the possible adjustments but haven't found an operators manual with explanations. I don't suppose you had a Corvette? There was a very helpful bloke on the Corvette forum with your username. I was Stingraynut there.

Lavender -you're right!

Gotrhythm yes the accelerometer is very low tech. I didn't know that before I had the pacemaker fitted. You'd think there would be other sensors, for instance an O2 sensor and then it could compare the O2 level and know I wasn't walking.