Had my office checkup this morning

All went well. I made sure before they started that the Upper Tracking Limit would be left at 150 even though I'm 82 yrs. The Medtronic rep looked at my report and agreed that I was handling it well and not pushing myself.

Another interesting thing is that my PVC's, both single and runs dropped a lot this last 3 months.

I've got estimated 4.5 yrs left on the battery, and the leads look as good as when installed in 2004.

I wonder if I will still be able to convince them to keep my upper rate at 150 when get a replacement at 86 yrs.

So I celebrated by driving out to the desert and hiking a 3 mile trail that climbs around 350'.

By the way we really have some great Medtronic reps here. Willing to take time to talk over some of my questions and work well with the cardiologist.

frank

11 Comments

:-)

by electricmom - 2012-04-09 07:04:39

Great news Frank! So glad to hear, keep it up~ Have a wonderful week Sheila

Wow!

by TITLE - 2012-04-09 09:04:42

You have 4.5 years left on a device that was implanted 8 years ago? Wow! You are a testament to your age and the attention to your health.
You and Moses! Congratulations on a great report!
TITLE

I mislean you

by ElectricFrank - 2012-04-09 10:04:43

The original pacemaker and leads were implanted in 2004. That pacemaker was replaced in 2010, but the original leads used.

frank

Good News

by Moner - 2012-04-09 11:04:15

Hi Electric Frank,

That's great news, I'm glad they kept your Upper Tracking Limit at 150, I know you had some concerns last week.

Have a good week.

You're probably out hiking again to celebrate.

You should be Medtronic's newest spokesman.

Moner

>^..^<

But, how many PVC's...

by donr - 2012-04-10 07:04:22

..did you have before?

I went from nearly 30% PVC's in one short period just before meds intervention to less than 1000 in a 90 day period. Now THAT'S a drop. I also functioned like a zombie. So, I modified my meds to where I am now - about 1-2%, which is on average a single every 2 minutes - who can even recognize that low a rate?

My experience is that you can comfortably tolerate up to about 10% if they are scattered singles w/ very few runs.

Don

Calculation

by donr - 2012-04-10 10:04:13

Frank: I calculate it based on a 60 BPM avg rate. Mainly because I can do it in my head when I see my report. That comes out to ABOUT 3.5 million beats per 30 day month. To get any closer would be ludicrous - like you say, you don't know when the singles & runs come. And, yes, were your PM to pace you only 1% & that 1% w/o a PM would kill you were it to happen in a single run.

This is the basis my Cardio & I use to discuss how things are going on a period by period basis. My PM is set at 75/XXX - but who the heck wants to grind out those numbers in your head - besides, When I look at my histogram every report, my AVG HR is OBVIOUSLY higher than 75 - it's probably somewhere near 85, but that's too messy to work w/ & just isn't worth it.

I recall the first time - in about Mar 2003 - that my cardio & I sat around & discussed my PVC rate. I had some G-d awful number of PVC's - like 15,000 & about bitrthed a full grown Texas Longhorn Steer on the spot. Then he said - let's calculate the number of beats you had in that period & we proceeded to do so - him on a piece of scrap paper & me in my engineer/teacher head. Came up w/ ABOUT 3.5 million as a number we could both remember for 30 days & have stuck w/ it ever since. I looked at 15/3500 & quickly concluded that a fraction of a % PVC rate was insignificant.

I do know that just before I got my PM I was in Bigemini (SP?) for several hours. I was so debilitated that I had all I could do to breathe. Any activity was exhausting.

Now, I know from experience that a PM cannot solve the PCV problem w/o meds, but when they put the PM in, I came out of the fog ready to take on the world, starting w/ Arnold Schwartzenegger! I felt that good. So - I must have had another issue besides the PVC's.

BTW: when someone gets exited here about their PVC rate, I always start an answer w/ "let's look at a HR of 60 BPM to see relatively how high a percentage of bad beats you have..." People are flabbergasted to realize that 60 BPM gets you 3.5 million beats per month.

I really don't think my Cardio ever had anyone ask him the question that I did before that lead us to calculate the BPM number.

I know that they are not evenly distributed across the period, but there are two approaches to grasping a problem - making rational simplifying assumptions that allow you to solve it; or making hideously complex assumptions that make the problem impossible to solve. Engineers who do the latter starve to death. I'll bet you belong to the first group!

Don

Answers

by ElectricFrank - 2012-04-10 11:04:25

I'm not really sure why they dropped so much. Their nature also changed from thumpers to more like just a skipped beat. The main reason for this is timing. The PVC interval has moved out to very near where a normal beat would occur. This makes for less overfilling of the ventricles which is the real cause of the heavy beats.

I put mine in a spreadsheet and normalize the result to PVC's/day. It takes some calculation since the pacer stores total number since last office visit. It doesn't reset the counter for Carelink phone checks.

So my singles dropped from 2334/day to 889/day.
Runs wen from 457/day to 6/day.

Don, They have offered me meds,when they were thumpers for over a year, but I decided to just ride it out. I seem to have the ability to just put things like this in the background once I have determined it isn't the sign of a serious problem. The opposite is also true. When I had the loss of capture episode where I was skipping 4-5 beats in a row even though the pacer was sending VP's I had very subtle sensations, but I knew something wasn't right. That sent me to my ECG, and ER. The advantage of all this is that my readings are pretty much pure baseline, and when changes for good or not so good happen they stand out.

One nice thing is that I have never had the slightest indication of afib, My sinus pacer responds nicely to exercise like I did with my hike yesterday. I alternated between hitting about 125, and resting down to 90. I could have gone on up to 130-135, but I was just enjoying myself and not trying to prove anything.

frank





Good Numbers, Frank

by donr - 2012-04-10 11:04:54

Frank: At 2400 per day, that's 100 per hour or about 1 1/2 per minute - not much different from my nowadays.

Pretty decent numbers. Beats the Heck out of 33% - which, I promise you, is debilitating.

Given the choice between 33% & dysfunctional & meds & some zombie feelings, but functional, I'll take the zombie, thank you!

Don

I agree Don

by ElectricFrank - 2012-04-10 12:04:30

Thats about the way my old Model A Ford ran with one spark plug wire disconnected.

At 33% it would be affecting circulation. That's a lot different than just being uncomfortable. Not only that the PVC's don't come at a nice even rate. I commonly take a 1 minute sample on my ECG and would see as many as 3 on it when things were really jumping and lurching. Sometimes one of those runs would have every other beat a PVC which is 50%. This is the problem with any statistical analysis.

Reminds me of the folks that want to have their pacer removed because it is only pacing 1% of the time. If that whole 1% was a continuous burst they would be dead.

By the way, where do you get the % reading for PVC's? All my printout shows is the number during the report period. Are you calculating it? You would need to have the total number of beats to do that.

frank

Engineers

by ElectricFrank - 2012-04-11 01:04:14

If I was an engineer worth my title I could at least come up with a 5th order equation to describe it!!!!

I never thought of it til now..next time I go in for a check up I'll take my Pickett slide rule with me. I use Excel for most of that sort of stuff these days.

Maybe I should change my calcs to PVC's/minute. I don't know why I made it daily.

I like your 3.5 million/month beats @ 60bpm. Now we need to come up with the warranty we are born with. I just figured the number in an average lifespan of 85. It's around 107 billion Good reason to sit around, watch TV, and drink beer. Save wear and tear on the old ticker.

I just had a thought. Why couldn't the pacer be designed to detect a PVC, and then based on the heart rate at the time pace a ventricular beat half way between the PVC and the next regular beat. That would eliminate the excess filling that produces the thump. It's the timing of the PVC that determines the discomfort.

frank

PVC Control

by ElectricFrank - 2012-04-13 12:04:58

If a pacer was set up to control PVC's we would have most of the population wearing one. I have had PVC's since my 30's. They really shook me up until my old doc just laughed. He told me of a young man who drove several hours coming in from trip a with his window down pouring cold air on him. He thought he was about to die of a heart attack. That was before emergency rooms and when we could still call our doctor in the middle of the night, and he called the doc at midnight.

frank

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