Confused About Rate Response


I have my interrogation report in front of me and wondered how I could tell from the print out that the rate response is off. Unfortunately I don't have the report from my first visit three weeks ago when the rate response was turned off (which completely cured my breathlessness which started as soon as the PM was fitted). Under the section headed rate response, it says:
Rate Response
Optimization - On
ADL Response - 3
Exertion Response 3
ADLR Percent - 2.0%
Activity Threshold - Medium/High
Activity Acceleration - 30 sec
Activity Deceleration - Exercise
High Rate Percent - 0.2%
ADL Rate Setpoint - 5
Upper Rate Setpoint 18

If the rate response is off, what does all the above mean? So which section on the report should I be looking at to determine whether it is off? My mode is AAI<=>DDD. I have a Medtronic Adapta Dual Chamber PM fitted for second degree heart block and I am only pacing about 6% of the time.




by SMITTY - 2008-04-17 01:04:45

Hi Sue,

I'm confused too. Like you My Rate Response is supposed to be off, but I must say that is what I was told and I never trust the people doing my checkups.

I am guessing you also have a Medtronic PM. Anyway, below are the readings from my checkup a couple of weeks ago. My numbers are in ( ). At least our numbers are about the same. Now let's hope Frank will come aboard and tell us what these numbers mean.

Optimization - On (On)
ADL Response - 3 (3)
Exertion Response 3 (3)
ADLR Percent - 2.0% (2.0%)
Activity Threshold - Medium/High (Med/Low)
Activity Acceleration - 30 sec (30 sec)
Activity Deceleration - Exercise (Exercise)
High Rate Percent - 0.2% (0.2%)
.ADL Rate Setpoint - 5 (15)
Upper Rate Setpoint 18 (27)


Waiting for ElectricFrank

by susanspurs - 2008-04-17 05:04:22

Thanks Smitty - I would really like to know what the numbers mean.

what I'd do

by CathrynB - 2008-04-18 01:04:09

Sue: The best person to explain what all of this means is the person who gave you the report -- your EP, cardiac nurse, technician, or whoever. Mine always hands me the report without my asking, and I say "can you walk me through this and tell me what a few of these items mean and what changes were made, if any?" I'm fortunate to have a caring, patient EP and cardiac nurse, and I know some of you do not have that, but it's important to understand these devices and our settings, so push for answers. My Rate Response Optimization also says "on", like yours, though I know the Rate Response Mode is turned off for me. I asked the cardiac nurse to explain that more than a year ago, and she did, but I was still at the stage of being on information overload and don't recall her answer now.
Best wishes in getting the answers you seek,

Found out a bit more

by susanspurs - 2008-04-18 06:04:05

Thanks Cathryn I have found out a bit more about it as I had to go back again today as the adjustments they made yesterday caused new problems.

I asked the technician how I would know from the print out that the rate response was not on and she said it would show in the first column under Modes. Mine is AAI<=>DDD and it would be AAI<=>DDDR if the rate response was on. She also said she didn't know why the Rate Response section showed all those settings but that mine was definitely off.

So I would still like an explantion as to what the settings under Rate Response mean if anyone knows.



by susanspurs - 2008-04-18 07:04:39

If the rate response is on an 'R' is added to the Mode. So my setting would read if the rate response was on:
instead of:
Mode AAI<=>DDD


more info

by kheming - 2008-04-18 11:04:47

I have a Biotronik and my printout looks different. Is there anyplace to go for an interputation?

Rate Response

by maryanne - 2008-04-27 08:04:13


Hope this helps....The rate response setting on the PM controls how the Pm responds to activity(how fast, how soon etc.)The setting can be adjusted in a variety of ways to optimize the response for you. I also found this for you....

"Rate-adaptive Pacemakers
When you're active, your heart beats at a faster pace or rate. Electrical system problems can sometimes keep your heart's rate from speeding up when you're active. Because of this, some single-chamber and dual-chamber pacemakers are also rate-adaptive. This means they can help change the rate of your heartbeat depending upon your activity level. So when you're dancing or doing a similar activity, a rate-adaptive pacemaker helps your heart beat faster. And when you sit down to rest, the pacemaker lets your heart return to a slower rate."

My current mode is DDDR with the mode switch allows me an increase of activity....I was in a ADDR setting and was hoping I could stay there as it would extend the life of my PM....but it was found that when I ws in that setting I had episodes of complete heart with tweaking of my Atrial lead and Ventricular lead pulse width now up to .40ms I seem to be able excercise better. I still think I need some more tweaking..but hey this is pacemaker number 4 for I am kinda of getting use to having the adjustments made....hope some of this information helped.....cheers!

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