Daily self test on PM

I just had by PM replaced in April 07 as it was time to replace battery. The new model they gave me does a self test everyday. Does anybody have information regarding this? I found out about it when I asked the Medtronic Technician to see what was happening at 1 and 2 am. as I was waking up while I was sleeping and unable to go back to sleep. They've set it now at 5 and 6 am, and now I sleep through the night waking up at 5 am! I told them I would like that feature shut off or to have it self test once a week/month, but they won't reset it, even though they could. Is this safe? I had heard on the news one time, that the electric shots that send signals to beat your heart with a PM can cause damage to your heart over time. Is that true? My plan is to call Medtronic and try and get more information. Please, if anybody has more info, let me know. Thank you!


Daily self test on PM

by SMITTY - 2007-12-23 09:12:20

Hi Bunny,

I wish I knew enough about your new pacemaekr to comment on what they have it doing and what you want it to do, but all that is way over my head.

But, as you will see I have commented on some of your questions which I have shown below. I am reprinting them here because I'm not sure that what I have said or the additional information I have included is exactly what you are talking about. I too have heard that having our heart constantly rely on a pacemaker to provide the impulse to make it beat weakens the heart over time. Frankly, I don't buy into that line of thought. It is my understanding that our PM only furnishes an impulse when the heart's natural PM does not supply one, or the one supplied to the heart is not strong enough to make the heart beat. While I know very little about the electrical system of the heart, it just seems to me that a pacemaker is only doing a job that our heart’s electrical system is not doing; therefore, it should have no short term or long term effect on our heart.

However, I am including excerpts from an article that I read on how a pacemaker can have an adverse effect on the heart. But I think the author of that article and me are talking about apples and oranges here. If you or anyone can enlighten me on this subject, I will be grateful.

Your questons - "I had heard on the news one time, that the electric shots that send signals to beat your heart with a PM can cause damage to your heart over time. Is that true? My plan is to call Medtronic and try and get more information. Please, if anybody has more info, let me know."

"In the modern era things are different. Pacemaker implantation is generally uncomplicated, most if not all of the technical issues associated with pacemakers have been solved. Programming of the device is now software-based rather than hardware-based. It's now possible to change "what kind of pacemaker it is" based on the physiologic needs of the patient.
In addition early recognition and treatment of the underlying heart disease have allowed patients to live much longer with the pacemaker being only part of a larger, more complex and comprehensive treatment of heart disease. Patients at high risk for sudden death are no longer treated with pacemakers but are now treated with devices that are combination pacemakers, implantable arrhythmia management devices and defibrillators.

Recently, we have learned that continuous pacing of the right ventricle is harmful to the heart in some patients because pacing the right ventricle is associated with desynchronization of the left ventricle, promoting congestive heart failure. This is why biventricular pacing has emerged as a new therapy for patients with heart dysfunction or heart failures who require a permanent pacemaker.

In addition, new technology has allowed us to pace the top chambers or atria without pacing the ventricle except at times when the pacemaker decides that right ventricular or left ventricular pacing is needed. It is only because of the technology developed by the implantable arrhythmia management device that we are able to offer patients these new functions."

Good luck,



by kmhayward - 2007-12-29 08:12:12


A little clarification...... Long term continuous RV pacing is bad for the heart as it is conductng the impulse in the opposite direction to the physiological electrical pathway, resulting in desynchonisation. Trust me i have studied this in depth!!!!!! However, this is why most pacemakers are programmed to be used only when absolutely needed. This may take some tweaking but that is the aim. Even if you are 100% paced 100% of the time, it still takes a VERY long time to cause any significant problems..... so relax there is really nothing to worry about here.
As for this self test..... this is called autocapture threshold control. The idea is that the pacemaker does a short test to ensure that the thresholds (ie the smallest amount of energy required to cause the heart to contract) are stable. Most people dont feel this, however some do. Others just think that they do. If you really don't like it, this function can be switched off to no ill effect. Talk to the pacing techs and ask why they want it on, alternatively ask them to programme it to a time during the day when you are usually busy doing something, and dont ask them for the specific time. Im sure you wont notice it then

Self Test Interval

by ElectricFrank - 2007-12-31 01:12:18

As long as your threshold levels stay relatively constant they should be able to set it for weekly self test. I had mine set that way for almost 3 years until I had something happen (probably a virus) that raised my ventricular threshold enough to cause intermittent capture. So now I am set for 3:30AM, but unless I happen to be awake which is rare I never notice it.

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