mode switch at ERI, not EOL

I'm coming up on the end of another battery and I'm confused about something the rep said. If I understood correctly, there will be a mode switch when it goes to ERI, rate response is going to turn off but everything else would stay the same. So, is it going to go from DDDR to DDD? He most definitely said ERI, not EOL, and he wasn't in a rush to schedule the replacement, didn't even move up my next appointment (3 months), just said to call him if I start having trouble working out. I've never felt anything when it switched to ERI before. This will be #5.

9 Comments

ERI/EOL

by zawodniak2 - 2015-10-14 09:10:19

Tracey --I believe when your PM goes into EOL your pulse will lock in at 65 BPM and all interrogation sensing is turned off to save battery life. They told me you have 3 months of battery life left at this point and it becomes imperative to schedule a replacement. This happened to me and I used a finger monitor to check my pulse. No matter what I did, I stayed at 65 BPM and felt it taking it's toll on my body in the days before my replacement. There always seems to be confusion on this terminology. I have a Medtronic, so the programming is probably different. If you call the manufacturer and give them your model, they should be able to clarify as well as a call to your tech or doctor. Have your ever had any lead issues in all your years of being paced??

modes

by Tracey_E - 2015-10-15 01:10:23

Dave, this one will be 6 years old in Jan. My longest was 7 so that's about average for me. There are a lot of things going on so even if it's shortening the life, I'm not going to mess with the settings. A few years ago, I could barely work out. Long story short, after two stress tests, the tech consulting with his network of contacts, my doc doing his research, they didn't know what to do so sent my files to SJM as a case study. My settings now are what the SJM engineers sent back and the other techs know not to mess with it! I can do probably 90-95% of what I want to do now. When I had a routine stress test last month, my rate went up at a good pace, and I stayed at a steady 170 for the duration of the test, ran until the very end, chatting with them the whole time.

Don, this was not some random person reading the report. It's the head guy, the rep who has taken care of me for more than 20 years, biomedical engineering background before his 30+ years with pacing. When it comes to settings, I trust him more than my doc.

I guess did not explain myself well. Things I am 100% sure of:
1. I am DDDR now, that is going to change and rr will turn off. I saw the screen.
2. I am not in elective replacement mode yet. I specifically asked.
3. This is my 4th time nearing ERI, but the first I've been told I will feel the mode change, only working out, not day to day activity. I never heard of that. I know it is unusual, THAT was the point of the question.

Interesting conversation

by JenSF - 2015-10-15 03:10:46

Hi all,

I'm afraid I don't have an answer for you, Tracey, but this was a super interesting conversation for me to read. In August I started feeling "funny" and sort of sluggish and realized that my pulse was lower than usual, but since I had an appointment coming up, didn't think too much about it. When I went in, the doctor said I needed a new pacemaker immediately.

Today, going back and looking at some BP readouts, I had a pulse of exactly 65 every time I took my BP since mid-August. I was clearly in EOL-mode and had no idea. The weird thing is at my previous check up in the spring I was told I had 17 months of battery time remaining, so I was totally caught off guard.

I guess a lesson for me in both increasing frequency of doctor appointments toward the end of battery life and paying closer attention to what my body is trying to tell me.

Jen

If that's true...

by donr - 2015-10-15 04:10:43

..things have changed since 2010 when I had a change out of PM. Promptly at `1222, Sat 5 Aug, mine quit everything except pacing me at 65 BPM. Thurs, 10 Aug at 1500, I got my new one.

My cardio's Head Nurse told me that would happen at EOL.

I think your Tech weenie got his/her tongue wrapped around the eye teeth & could not see the cheat sheet they were reading from.

Don

Settings

by Good Dog - 2015-10-15 06:10:58

Tracey,
With regard to your settings........I hear ya! I also trust the Medtronic Rep more than my Doc.

It sounds like you are doing really well.

I find it interesting; I don't want anybody messing with my setting either. My pacer Tech must think I am neurotic (I guess that I am), every time I get a pacer check I always remind her not to change anything, and if she feels she needs to, she'd better check with me first. I want to make sure she knows!
I wish I could answer your question, because the situation you describe doesn't make sense to me.

Dave

Rate Response

by Good Dog - 2015-10-15 11:10:40

Tracey,
Just another quick question.............
I spoke with the Doc at the cleve clinic about turning-on my rate response. I've been urged to do so by the Tech there and my own Tech. They see that my pulse is in the 50's and 60's a lot. He asked how I've felt? I told him that I have had no problems or issues. I have felt good. He also asked if there is anything I'd like to do, but felt that I lacked the energy or stamina? I said: no. I walk 2-3 miles/day, light workouts, use a push mower to cut about 1/3 acre, and all sorts of physical activity carrying heavy boxes and stuff for my business. I can't do the strenuous workouts anymore due to arthritis, not the PM. He said; "well then, don't have it turned-on". He further said that it would reduce my battery life. Since I've gotten 12 years out of this one, I decided it best to leave everything alone.
My question is; how long as your battery lasted? I know there is more that goes into battery life than just rate response, but I am curious?

Sincerely,

Dave

ERI/EOL

by Tracey_E - 2015-10-15 12:10:41

I have been through this 4 times, so I'm not new to replacements and the modes at the end. I have SJM. ERI is elective replacement and it's fully functional during this time. After approx 3 months of that, it goes to EOL which is end of life, when you have limited function. (Actually, they don't use EOL anymore but I can't remember the new name so I'm using the old one. Whatever you call it, it's the last mode before it goes kaput when it has limited function)

My rep told me very specifically today that when I switched to ERI- NOT EOL- it would change modes and lose rate response. I'll still have the usual upper limit for ventricular pacing and all my other normal function. It's simply going to switch from DDDR to DDD, if I understood correctly. I never heard of this so that was my question, has anyone else had this in between stage between full function and EOL.

zawodniak2, I had a lead replaced 5 years ago. My other original lead (1994) is still working. Both leads are functioning well right now, no talk of replacement this time.

Dave, I'm fortunate that I've had the same rep since my first placement. He's wonderful and always willing to explain things to me. He warns me when ERI is coming and switches to monthly appointments instead of quarterly. As soon as it hits ERI, we schedule replacement. They've never let me even get close to EOL. That's why I was so surprised today when he said call him if I start having trouble working out before my next appointment. He doesn't think it'll switch modes before then but wanted me to know about it just in case so I'll recognize it if it happens. The only time I use rr is when I work out so he said that will be the only time I'll feel it. Weird.

ERI

by Good Dog - 2015-10-15 12:10:49

Tracey,
I have been reading a lot of stuff. I have a Medtronic PM and from what I've read, the PM calculates the amount of battery life based upon the settings, options and average amount of pacing (based upon history). It goes into ERI when it calculates 3 months remaining with a safety margin). I am not sure, but it seems that when it goes into ERI, it doesn't appear that it does anything different. It doesn't start to shut-down options until it gets to EOL 3 months after ERI. I am not sure of any of this and I am a little skeptical based upon what I have been told, but that is what I read.
So if/and you find-out for certain, please let us (me) know. As you know, I am scheduled to get my generator changed next month. I have received so much contradictory information that I am just not sure of anything right now.
Sincerely,
Dave

your question

by hopefulheart - 2015-10-16 08:10:23

Hi, Tracey
When I saw your post, I thought you must have information to share. You are usually the one helping someone else understand what is going on. I am sorry I cannot help with your question. I know you will keep researching until you have an answer. Take care.
hopefulheart

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