Had My First Interrogation...Early

I have some paper work from my first interrogation....I can't decipher it! Tha doc says he turned the pulse amplitude down to 1.50. I don't see where it was higher in the first place.

Could one of you that knows how to read these tell me what I am looking for.....the important information.
I only have a single lead in the atrium. I have SSS. I am only being treated for the brady right now. The doc wants to see if the new rate wont help settle down the tach....which only occurs with exercise. But right now...thats not looking promising....I was going from 50 bpm to 100 bpm sitting in the chair.

If someone could tell me what to post...I could and maybe you could tell me what it means.

Also....I have been checking my HR just for the heck of it...to see if I am right at my bottom rate which is 50.
I was for the first 3-4 days. Yesterday I got a reading in the 40's several times. Could my pacemaker not be working right since he tuned the amplitude down? Or is it likely my device is reading wrong all the sudden....hmmm. I don't want to call the doc if I don't have to.

Thank you so much Holly

3 Comments

PM Info

by SMITTY - 2008-08-01 05:08:45


Hello Holly,

What I have to say about your doctor is not going to be kind, so you can stop reading now if you wish. But I think the fellow is trying to lay something on you that he knows dang well you will not understand. And my
guess is he does not know much more about it than you so he throws out these terms to keep down the questions. If I'm totally wrong about the fellow, I'll be sure and apologize to him next time I see him.

I looked up some definitions of pulse amplitude. One I got is:

Pulse amplitude: In telecommunication, pulse amplitude is the magnitude of a pulse parameter, such as the field intensity, voltage level, "current level, or power level.

So then I looked up amplitude and got this:

The extent or range of a quality, property, process, or phenomenon: as a: the extent of a vibratory movement (as of a pendulum) measured from the mean position to an extreme b: the maximum departure of the value of an
alternating current or wave from the average value

Just how those can be translated into what you were told about your PM is beyond me. But we are lucky here because we have Frank that will explain these things to us, I hope.

For comparison, I can tell you what I have in the way of settings on my pacemaker.

Amplitude 2.500 V
Pulse Width 0.40 ms
Sensitivity 0.40 mV
Sensing Assurance Off
Pace Polarity Bipolar
Sense Bipolar
Lead Monitor Monitor Only
Maximum Impedance 4,000 ohms
Minimum Impedance 200 ohms

I will try to give you a little insight into what is going on with yourheart rate, based on my experience.

I have been going through something very similar to what you’re experiencing, I think. Mine started in Mar. '07. Now my pacemaker has a low setting of 70
and a high of 120. For months and months anytime I did anything physical my heart rate would become irregular and bounce around from about 45 up
to 70. In spite of what I had been led to believe my PM would not keep my HR from going below 70. To compound my problem when it got into the 40s I
would have angina.

I don't know how many visits I made to various doctors and the pacemaker clinic. I remember one nurse/technician starting to do a checkup and
after sitting there for a minute or two looking at the monitor she blurted out "I don't understand this, your heart rate is only 47 and the low setting on your pacemaker is 70. Give me a minute and I'll be right
back." In about 10 min. she came back and by then my HR was up to 70, so she muttered and went on with the checkup. I never got an acceptable explanation for that and it still goes on. Not as often as it did for many months, but just this morning I went through about an hour of 46 to 72 HR.

My reason for taking your time and telling you this is just to say don't worry about your heart rate. The odds of that pacemaker screwing up and not working is somewhere between very slim and none. You are much more likely to be struck by lightening than for your PM to mess up.

Our pacemaker doesn't just automatically send out an impulse every so many milliseconds to make our heart beat unless the heart rate is very low. (More on this in a second) It checks to see if our hearts natural PM is going to do its job and if it doesn't detect an impulse coming form the natural PM, then your manmade job will send the necessary impulse. However, therein is the rub. The manmade PM check to see if the heart's
PM is sending a signal and sometimes gets fooled. The heart’s PM may indicate it is sending the impulse which the manmade PM detects and does
nothing. But, that impulse from the heart's PM may be too weak to make the atrial contract, so in effect your heart skips a beat. In other words your heart's natural pacemaker faked out your man made pacemaker.
Apparently there is some heart rate low point at which the manmade PM will say to heck with this and take over the job of keeping your heart beating.

So, use your fingers, or whatever electronic device your want too to check your heart rate, but don't put too much emphasis on the number you get UNLESS YOU ARE HAVING CHEST PAIN OR ARE FEELING POORLY. In that case no mater what your hear rate, call your doctor. In fact a number of years ago, I had a heart attack that came within a minute or two of killing. It started while I lying bed and my heart rate suddenly went from my normal 70 BPM to over 90 BPM. So while is very important because we know we must have one to be alive, it is not all that important, so long as it is reasonably steady and into the 150 BPM and above range when we are doing nothing to case such high number.

Good luck

Smitty

Thank You Smitty

by LIVE_STRONG - 2008-08-01 06:08:50

I think I understand a bit more now! I will post my info later and maybe it will mean something..I am curious about the percentage of time being paced. I will be back in a bit to post.

Hugs...Holly

Settings

by ElectricFrank - 2008-08-02 01:08:47

As Smitty mentioned something doesn't make sense. Here are some things to look for on the printout. mine is a Medtronic pacer and a different make may use slightly different names.

There should be a section which gives the make and model number of your pacer and the leads. Check to see if it shows only an atrial lead, ventricle lead, or both.

Another section will give the mode. You should see something like DDD or DDDR, but there are a bunch of modes. This will tell us what is being paced and under what conditions.

There should be section showing Rates. These will help understand what sort of rate control you have.

If you could start by posting these maybe we can help.

frank

You know you're wired when...

The meaning of personal computer is taken a step further.

Member Quotes

The pacer systems are really very reliable. The main problem is the incompetent programming of them. If yours is working well for you, get on with life and enjoy it. You probably are more at risk of problems with a valve job than the pacer.