Weird behavior on on Medtronic Azure XT DR MRI Surescan

Hi everyone, new to the forum and grateful for any advice on this issue.

I am a very new pacemaker owner, having only had my device 2 weeks today.

I have a two lead device treating a "sick sinus syndrome" that was diagnosed in a regular checkup (25 bpm HR) and a PM fitted immediately.  I also have an exercise induced right bundle branch block, that i have had as a teenager (normal 42-45 RHR) that has not caused me any issues. In all other ways heart is healthy. I am/was reasonably fit, run anywhere from 5km to half marathons and swim 2-3 km per week.

Device is set with a low HR of 50, Sleep mode of 45 and a "high" of 150, not exactly sure what the high end means. My garmin data shows that pre-op on walks my HR would normally climb to 110-130 and anywhere from 150 to 175 on runs, around 42-45 RHR.

I went for a walk today (5km) and about 10 mins in I felt a thumping and tight sensation in my chest, and my HR shot straight up to 150 and flatlined. I was not out of breath per se, and slowed down a little which made the chest feel better, but my garmin recorded a flatline HR of 150 the rest of the walk other than when i stopped for a few mins. ( i wish i could post the pic!)

Quite concerning, not sure if it is settings or not responding correctly to input from one of the leads, or a problem with lead placement.. Would appreciate advice from anyone who has experienced this or similar and/or has knowledge of the Medtronic device and its best setup for those who exercise a bit.

2 Comments

Upper rate behavior

by Rch - 2024-09-29 20:13:42

Hi

I understand the indication for the PM is SSS with significant bradycardia, and the PM is dual chamber. If you could look into the records and tell us what mode it's set at like DDD, DDDR, AAI, AAIR it would help us to give our opinions as to why the rate freezes during maximal exercise. Also, 2 weeks is a little to early for the leads to set in and give stable and reliable rhythm across the broad spectrum of rest and max exercise. There is also the question on how reliable are the HR recorded by Garmin. Radial pulses would be more accurate. 

The thumping sensation was probably your RV lead activating your heart

by crustyg - 2024-09-30 02:32:07

I've been paced RA only for five years and earlier this year we turned on my RV lead - and the sensation was much as you describe it when the RV lead kicked in.  Most unpleasant.

I persuaded the EP-techs to reduce the RV pacing voltage (at the cost of doubling the pulse-width) and it felt a little better.

Get your device settings and compare the pacing voltages, RA and RV.

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