? for my electrical engineers friends

85 years old, single lead to ventricle, complete AV block, Afib....Lots of SOB last couple of months. Could it be related to change in setting a couple of months ago ? I asked what change was for and told that it would make it more "sensitive". The cardiologist had asked for it. My high rate episodes have not been more than once every 6 months and very short. Thanks for any suggestions..
aldeer

4 Comments

Aldeer

by Grateful Heart - 2013-03-01 08:03:27

I am the farthest removed from an electrical engineer but if your SOB occurred around the same time as your setting change then I would think chances are it is related. If you were feeling well before that, I would ask them to put the settings back to where they were and see if that feels better for you.

Take care,
Grateful Heart

thank you, Inga

by aldeer - 2013-03-02 01:03:29

Thanks for the info, Inga

Sensitivity

by golden_snitch - 2013-03-02 10:03:14

Hi Aldeer,

the SOB could be caused by your atria and ventricles beating out of sync due to the Afib, and maybe also by asychroneous beating of your ventricles as the right ventricle is stimulated by the pacer, and the left is not. The latter can in fact lead to some stage of congestive heart failure. SOB would be a typical symptom of that. When was your last echo?

The "sensitivity" of a pacemaker is the voltage level that must be exceeded to detect a P wave (beginning of atrial contraction) or an R wave (beginning of ventricular contraction). Basically, if you look at an ECG it's the height of the waves: the lower the voltage, the more flattened the wave, and the higher the voltage, the higher the wave. So, if you make a pacemaker more sensitive, the voltage needs to be lowered, so that the pacer can detect even very little waves. Changing this setting should not lead to any symptoms. As far as I understand it just helps the pacemaker to detect your own underlying rhythm.

Best
Inga

little correction

by golden_snitch - 2013-03-02 12:03:53

Just realized that I made a little mistake: The P and R wave do not only mark the beginning of atrial respectively ventricular contraction, but the full contraction.

Inga

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