How to Read Interrogation Report

how to or what to look for on report

by new to pace.... - 2024-05-21 18:10:01

I think that these 2 reports are really to soon to really know how your pacemaker is working. 

   I contact my pacemaker  clinic after each quartely remote transmission.  Asking for the "log events" which gives me the day an times of some of the recorded events,  not all of them.  The battery remaining.                                                                                             

   If there is a major event the cardiologist will call and tell me.  Generally i have an explanation for her.  Sometimes a reaction to a supplement  or for me it is a bad food reaction causing A-fib  high  and fast beats.  I also keep a log of when i think something has happened and then compare.  Most of the times i am wrong.

For me i look at the summary which is at the bottom of the first page.  That gives the totals .  I also look at how many months are left on the battery.  Which at times varies as it depends on how often my pacemaker kicks in.

new to pace

New to Pace

by Andiek11 - 2024-05-21 19:58:25

Thanks.  I'll keep an eye on those portions of the report.

You are getting ahead

by Gemita - 2024-05-22 02:09:34

Andie, as New to Pace has mentioned in her first paragraph, the first thing I would say is that an interrogation report 1 day and 13 days after the implant is not perhaps going to be of real benefit while we are still healing, when we can expect our heart rate and rhythm, not to mention our blood pressure, to be volatile.  

I can remember that my first report within a few hours of implant showed some very worrying high atrial heart rates (in excess of 200 bpm), new arrhythmias (including Atrial Flutter) were seen for the first time.  I recall, I also had a high percentage of ventricular pacing.  At 3 months when things had steadied, my heart had started to heal and I had got used to being paced, my ventricular pacing percentage had dropped from 20% after a 24 hour check, to less than 1% at 3 months, with atrial pacing at 98% in AAI pacing mode.

You will find the following in your interrogation reports:

Your initial diagnosis, for example left bundle branch block and low EF.  Make sure this diagnosis is complete and accurate from the start.  All reports give important info on Battery/Lead status, Mode of pacing, detection rates for the recording and storage of Events like an Arrhythmia, including PVCs, Lower rate, Upper tracking rate, Paced and Sensed AV delay, Percentage time spent pacing in each chamber.  Any important event, like a fast or significant rhythm disturbance will be reported, like for example Ventricular Tachycardia.

Parameters Report will contain all the important settings/instructions your EP has given to your pacemaker to carry out its daily functions.  This will be important and you should learn what these settings will do.  For example your Rate Response settings, your Refractory Blanking periods, your Arrhythmia interventions.   At the end of each page, look for any “notes” or “observations” of anything significant that might have been found.  Follow these results carefully and ask to be told when they make changes to any of these Parameters, in case they adversely affect your well being and cause symptoms.  

Your interrogation reports will give an Arrhythmia Summary Episode list, the time spent in each arrhythmia and the highest/lowest heart rate.  Remember, these reports will only give info from each chamber you are paced in and only provide info your EP has set up to be reported/stored.  In other words, for something to be stored, it must meet the requirements (parameters) set up for its recording and storage which is why some of us still need external Holter occasional monitoring to pick up ALL rhythm disturbances. 

There will be a lot of graphs and even some ECG tracings of any important Events (like arrhythmias) contained in your interrogation reports although I realise that you do not presently suffer from significant arrhythmia episodes, only some PVCs. 

To recap, the following will be important to learn about:-

. the battery and lead status especially as they age

. the % time you spend pacing in each chamber

. your pacing Mode, your Upper/Lower rate limits, any monitored Events like High Heart rates or significant Arrhythmias

. In fact ALL your Settings and their set Parameters

Google Medtronic Academy followed by the setting you are interested in, for example Medtronic Academy Mode Switch, Medtronic Academy Rate Response which will bring up details of the programming and features of each Setting.  You can also find all this information in your Medtronic manual which I hope you have downloaded?  Well off you go student Andie and we look forward to your future challenging questions!

Gemita

by Andiek11 - 2024-05-22 11:32:36

Thanks (again).  And I agreed that it is very early days.  BUT, to be fair (lol), I didn't ask for the report (athough the thought crossed my mind).  The report showed up in my EMR and I was notified of a "new" test result, so of course I'm gonna read it for no other reason than to see where my baseline is at present and ooooh-and-ahhhhhh over changes I see in future times.  ;-)

I can see already where my atrial pacing has dropped from 21%-17% which makes sense since the only time i pace in the atriumis when my natural HR falls below 60.  This mostly happens at night (sleeping) but it also corresponds to when I *think* I'm experiencing the ectopic beats.  One of my asks at my 3 month is to explore lowering my lower limit to 50 - much closer to my natural lower limit.  This could also mean less pacing in the atrium which to me sounds goo.

My left ventricular pacing is at 100% which is the sweet spot they wanted since my poor left ventrical hasn't received a direct signal for over 27 years.  And as you mentioned, I see no indications of any other arrythmias. PVC's show <.1% and no recorded PAC's.  So all looks good to my untrained eye.  I can't make heads or tails of the ECGs since they appear so "cramped" but I'll trust they don't show anything of note / concern or I"m assuming someone would have mentioned it.  

Thanks again.