Which data represent the percentage of pacemaker you are dependent on

Pacemaker dependence

by Gemita - 2024-09-11 05:14:52

Smopace, are you asking about the definition of pacemaker dependency in general?  Yes the % of time we spend atrial paced (AP) or ventricle paced (VP) gives us a good indication of our level of dependency in each chamber for either sinus node dysfunction or heart block.  

Some of us are 100% dependent on our pacemakers in both the right atrium and right ventricle.  Other members are pacing lower percentage amounts in one or both chambers.   Total percentage atrial or ventricular pacing can change, depending on many factors, including pacemaker settings, so it is not always reliable as an indication of your dependency.  How we feel is important.  If we feel well, we are probably pacing for the right amount of time in one or more chambers.

Let us say that if a pacemaker was truly necessary (either for severe heart block or severe sinus node disease) the patient would probably have presented with symptoms requiring urgent medical intervention.  That would be my interpretation of need and dependency.  In other words, if the patient had their pacemaker turned off, they would probably not survive for too long or would become extremely unwell very quickly without emergency medical assistance. 

I am pacing 100% in the right atrium with very little ventricular pacing support needed (around 3%) although sometimes I need regular ventricular pacing too.  I pace in the right atrium because my own heart would beat far too slowly (in the 30s bpm) without my pacemaker.  I sometimes get heart block symptoms too, when I will need right ventricular pacing support.  I would not perhaps be regarded as totally pacemaker dependent since I would still have an underlying rhythm of my own, but I would get into trouble very very quickly (syncope was my presenting symptom) if I didn’t have pacemaker backup.

The fact that your father has a pacemaker is an indication that he would not manage well without one.  Pacemaker dependency is difficult to define though and the indication for a pacemaker is often based on symptoms.  If I had been symptom free and healthy with heart rates in the 30s bpm, I don't think I would have received a pacemaker

VP

by piglet22 - 2024-09-11 06:03:18

This is the reference to it from the Medtronic Ensura device.

The data might be presented differently in your case, but just gives an idea.

Table 36. Rate Histograms data Rate histogram data is available only as a printed report. The report shows the distribution of ventricular rates recorded since the last patient session and in the period before the last session. The histograms show the percentage of total time paced or sensed for the following event sequences: ● VS ● VP

av block?

by Tracey_E - 2024-09-11 10:11:04

If he has av block, 100% or close to 100% ventricular pacing is perfectly normal. 

VP usually refers to ventricular pacing. 

100%

by Lavender - 2024-09-11 11:14:56

I have complete heart block-my AV node doesn't function. I am 100% dependent on my CRT-P. 
 

AV block

by smopace - 2024-09-11 15:31:31

My father has "Frequent 2° or 3° AV Block". 

Total VP 99.9%

AS-VS <0.1%

AS-VP 30.2%

AP-VS <0.1%

AP-VP 69.7%

Figures

by piglet22 - 2024-09-11 19:10:01

I'm not going to attempt to decipher these.

99.9% total VP pacing is what it says and quite normal for CHB.

Note that the total VP figure of 99=9 is the sum of AS-VP and AP-VP.

Where I'm uncertain is the actual significance of things like AS-VS.

It's obviously very low and ties in with the high paced percentage. It suggests that that there are very few sensed pulses.

Hopefully, someone will fill in the gaps.

I'm 100% paced atrial and ventricul and mostly feel fine

 As I remember, only in the first few years out of nearly 20, were the figures less than 100% It's the natural progression of heart block, but nothing to worry about.

interpreting

by Tracey_E - 2024-09-12 10:33:24

Total VP 99.9% Ventricular pacing

AS-VS <0.1% Atria sensing ,ventricular sensing. Means both are just watching, not pacing

AS-VP 30.2% Atria sensing, ventricular pacing. Means only v pacing

AP-VS <0.1% Atrial pacing, ventricular sensing. Means only a pacing. 

AP-VP 69.7% Atrial pacing, ventricular pacing. Means both chambers are pacing