Office Checkup

After sending a Carelink on 1/7 they called on 1/14 for me to come in for office check. After we get it settled that there were to be NO changes without my OK, we agreed on lowering the ventricle pacing voltage from 3.5V to 2.25Volts to increase battery life. The higher voltage was set several years ago when I had a loss of capture event. I've reminded them regularly that the self tests, Carelink, and office tests showed the lower voltage was called for, but they were concerned that I might lose capture again. For some reason they suddenly stopped worrying about it.

I'm happy to have it set lower both for longer battery life and I have a feeling it is easier on my heart. The worst that could happen is that I lose capture completely and die, so nothing too serious. I wouldn't complain if it happened!
LOL

All else looks great. My PVC's have gone down to less than 300/day from a high of 3000. Lead impedance's stay the same as went they were installed in 2004.

My only problem is that I have nothing to complain about, or get depressed about. Maybe some day.

frank

8 Comments

Hi Frank!!

by donb - 2013-01-15 08:01:47

Just reading your posting, I had my ventrical settings also lowered about a year ago as my (good looking) St. Jude rep
gal suggested it would be easier on my ventricals as I was 80 the time. As I had my under muscle PM take a ride they had to remove it & replaced it with a Medtronic again, now my 5th.
I don't believe they set up my settings as my resting rate fell off to low 50s'. So a few weeks ago I had their rep check me & said I'm at 60-130. So not changing any leads just the generator it has taken a couple months for my HR to settle down to a solid 60 which this old body has memorized for 21 years & more.

Hey, how about this flu bug ?? AS I have the world's most touchy Vegal nerve I've been told to avoid restaurants & crowds of people as my PMs' just can't overcome the vegal attacks completely so as you say, what can be worse? You just die !! Oh, also want to mention I'm working on my 82nd year since Sunday, as a pessamist my thinking of being 81 is haywire as I'm into my 82 figure now, or least working on it So Frank, just stay with us as this site will dry up & blow away without you.
DonB
dsbauer1010@sbcglobal.net

I'm with you

by ElectricFrank - 2013-01-15 09:01:03

The engineer in me gives the urge to round up numbers once they pass the half way mark. So I call myself 83 even though the actual birthday is in June.

When they replaced my Medtronics in 2010 I had a very definite agreement with them that they would simply upload my settings from the old one before removing it and download them to the new while I was still in OR. In fact I reminded them of it while I they were stitching me up. The Medtronics rep assured me that they had done it.

A few days later I noticed that my HR was showing the usual signs of hitting the upper limit. So I got on my exercise bike and pedaled away while hooked up to my home built ECG and sure enough I started skipping beats at 120bpm. So I called the Medtronics rep and asked what the deal was. Turns out that the programming computer software automatically revised my upper limit according to my age. He arranged to see me and over ride the the setting. So I wound up back at my 55-150 settings that I have had since my first pacer. My poor old heart won'[t go to 150 any more, but it handle 130 just fine. I have even pushed it up to 140 just to check. I keep track of my HR and try to keep it under 130 normally. I just want the extra room to go higher. Like I told the cardio, if I'm being chased by a bear in the woods I would rather die from cardiac arrest than be eaten.

Take care and have fun. That's what counts.

frank

Humm

by jeanlancour - 2013-01-15 11:01:05

Don't think bears eat desert rats. I could be wrong, I have been a time or 2. Jean

Loss of Capture ala Frank

by ElectricFrank - 2013-01-16 01:01:35

I'll try!

In my case for some reason the voltage my ventricles required to response with a beat increased to a level higher than the pacemaker was set to send. Actually, the pacer was just at the threshold so most beats were happening OK, but I would get a spell where it wasn't enough. The result was that I would "flat line" for 4-5 beats. I was alone at home and felt it happening so I used my ECG to check what was happening. I would see 4- 5 pacer spikes but no beat. There was once that there was a longer flat line than that, but I wasn't hooked up.

As a reference on my latest checkup the ventricle threshold is 1.125V at 0.64ms. The setting is 2.250V at 0.64ms, which gives me a 2X safety margin. It was set for 3.5V which is a 3X margin. For a about a year after the loss of capture it was set to 4X in case the condition returned.

It was an Interesting experience. I was sitting in my recliner when my heart just stopped beating. I knew I had about 15 sec max before passing out, and just peacefully sat there waiting to see what was going to happen. I never did get light headed but must have been close.

So I knew it wasn't a good idea to drive to ER even in our small town so I called 911 and asked for a ride. I tried to tell them I was OK, was just trying be prudent. Even so they rolled all the sirens and lights. The funny thing was that the first vehicle on the scene missed my house and stopped several houses down the street. I was feeling fine so ran down the street and flagged them down. They backed the big fire truck up to my place, and got out all gurneys and equipment. After following me into the house they asked where the patient was located. I said "its me". Very funny.

Then I chose (refused according to the records) not to have a saline drip line for the 5 minute ride to the hospital. In the ER I did another flat line for long enough to set off the alarms, but still not enough to pass out. They came running into my cubical and found me reading a book.

Long answer and more than you asked. This last part gives some idea of why I deal with this stuff the way I do. There is a profound advantage in being content with dying. Sitting there with no beat is actually exciting in a way. I really feel that it will start back up if it can, and otherwise it doesn't matter. If I knew I was going to die in 10 minutes I would hook up the ECG so I enjoy watching it happen.

There is a serious part of this also. I don't contribute to the problem at hand by flooding my body with fear and stress. As I've said before I don't get short of breath at times like this. I get "long of breath".

By the way I'm not alone in this sort thing. I saw a presentation at a biofeedback conference of the physiological response of several test pilots who died in crashes of experimental aircraft. The thing that stood out was that in the final minute or less when they knew they were about to die and could do nothing about it, they were calmly reporting flight data to the ground. Or Apollo 13 "Houston, we have a problem" when they were several hundred thousand miles from earth in a failing spaceship.

frank

Hmmm

by ElectricFrank - 2013-01-16 01:01:53

Needling? Who me???

It's been so dry in Calif that the bears will eat anything.

The weather is supposed to warm up a bit so I'm thinking about going over to Death Valley for the day soon.

frank

Hi

by Moner - 2013-01-16 02:01:24

Hi Frank,

I know this sounds stupid, but what does it mean if you loose capture completely?

Does this mean the pacemaker cannot sense when you need to be paced?

Hope your friends are over the flu by now.

Moner
>^..^<

Thanks!

by Moner - 2013-01-16 05:01:42

Hi Frank,

Thanks for the explanation, it makes more sense.

I like your attitude to many things.

Moner
>^..^<

Hi, another one

by Ramnarayan - 2013-01-16 07:01:07

Another guy ignorant of "capture" completely. Pl explain.
Have a great time.
Ram

You know you're wired when...

Your device acts like a police scanner.

Member Quotes

At age 20, I will be getting a pacemaker in few weeks along with an SA node ablation. This opportunity may change a five year prognosis into a normal life span! I look forward to being a little old lady with a wicked cane!