mode switch

Hi During my latest check-up I nooticed the word Mode Switch which apparently was detected by the pacer during the test which as perfect after more than six years since implantation. I feel very well and have no problems. They say that I may have atrial fillibration but I feel nothing at all. Cardial surgeon suggested to continue with Microphyrin 75 daily and Omega 3 but NOT go for Comadin which is a pain in the neck drug!
What is this Mode Swich that the test technician mentioned in his report should I worry? By the way I am a 84 year male in good health all latest blood test were perfect no remarks noted. Moreover the latest checkup indicated that mt PM still had aboyt a year and half life left in the battery, should I try to ask them to replace them before the time elapses or wait until I get some indications that the batteries get weaker and problems arise?
Thanks my good friends for any advice you can give an old comrade
Dave

5 Comments

A-fib

by davide - 2012-11-13 03:11:53

Hi Smitty
thanks ever so much for your comment which is very reassuring. Regarding the A-fib when the doctor doing the regular PM check came up with Coumadin I decided to fight this by consulting the best physician I could lay my hands on and he being a top specialist advised me to keep away from that terrible drug. What he suggested was to continue taking the daily dose of microphirin 75 and add Omega 3 also daily and sofar it works thank the Lord.
In fact I underwent a general cardial check two weeks before the hospital PM check and the cardiologue said that all was OK so it seems that someone is mistaken somewhere. I am about to have the second annual PM check up in two weeks and feel fine so it must be OK and with about a year or more to go I guess I should stop worrying over the A-fib. Thanks again fro your friendly note I wish you all the best of health and maybe my doctors advice with the Omega could help?
Dave

You may have AF?

by Roys - 2012-11-13 11:11:24

Hi Dave
How come they don't know if you have AF? My PM will record even a 40 second episode of AF. I don't take coumadin, but I give myself a shots of Clexane if I get AF, usually 4 shots for one episode is required.

Cheers Roy

PM Mode Switch

by SMITTY - 2012-11-13 11:11:34


Hello Dave,

Or should I call you Mr. Dave since you are a year older than I am. Anyway, don't give that "mode" switch another thought. Our PMs have several modes in which they can operate. The mode in which it is operating is selected automatically by the settings of the PM. During a checkup a magnet is placed over the PM and this allows the nurse/tech to change the PM into various modes.

That is correct for all but the EOL or VVI mode which the PM will go into when the battery reaches a certain level or strength. This mode switch is made when the PM calculates there is about 3 months life left in the battery. You will know when this happens because your PM ceases being an on demand PM and goes to full time control of your heart beat. At that time your HR will be 65 BPM which will be a different HR from what it has been helping your heart maintain.

In my case when this change occurred my PM was overriding beats coming from hearts natural PM. This gave me a very irregular HR. While it was not painful, it was very uncomfortable and noticeable.

As for the A-fib, I do not feel mine unless my HR goes well above 110 BPM. Then I get short of breath. There are medications, or other means to help control A-fib. As for the Coumadin I couldn't agree more with your dr about it being a pain in the neck drug. My dr has me taking it and I threaten to stop it every day but so far my child bride of 63 years convinces me I should continue taking just in case it may prevent a blood clot during an episode of A-fib.

Well, Dave that is about the extent of my typing ability today and while you have more questons I'm sure some of the other members will answer them.

Good luck,

Smitty

AF

by davide - 2012-11-24 02:11:24

Hi Smitty
I value your comments and advice and would like to know hat you think about the following:
Ywo years ago I underwent a full cardiac routine check-up which included Echo and EKG and no problems were recorded and I received a clean bill. That was when I was 82. Two weeks later I had the routine check at the hospital for my PM and this was also OK after 5 years in. Surprisignly the Technician told the doc that he thought that I had AF and the doc sent a note to the cardiologist suggesting him to have me take Coumedin. When I asked him why after two weeks all of sudden this was necessay I was told that these changes can happen and I should take this medicine. I refused and went to second opinion with a professor who discarded the Coumadin and told me to continue instead with my Microphirin 75 and add only Omega 3. I feel well no AF and two EKG checks recorded some sporadic AF but doctors did not recommend changes. Do you think that I am doing the right way refusing Coumadin under such circumstances? I am about to have a routine PM check and they will probably again babble about that horrible drug as they do every time!
Like to know what you think
Thanks
Dave

asfasfasf

by boxxed - 2012-12-06 01:12:44

Mode Switch is when the device detects a variant of an atrial tachycardia and switches to an inhibit mode. Like going from DDDR to DDIR.

What's the difference? DDDR and "typical" settings will track atrial events. Meaning if it sees an Atrial event, it'll trying to pace in the V unless it sees the heart did it on it's own. This could become dangerous if the atrium is in aflutter or afib and the atrium is firing @ 300+ BPM. In DDDR with afib, the device could inadvertantly be pacing and "tracking" much faster than a person needs. So say if the device is set with a Max Track Rate of 150. A person is in a-fib and their atrial events are being counted @ 350 bpm. That means that the device WITHOUT a Max Track Rate would try to go 350 bpm in the ventricles. WITH Max Track Rate it'd be stuck @ 150 bpm but would want to go higher.

What Mode Switch does is INHIBIT instead of Track. It recognizes that the heart is doing something weird with the top chambers, firing faster than normal, and refuses to try to match 1 for 1 with the atrium until the device detects that the atrium has settled down to more "normal" rates.

Pretty much, and I wouldn't use this generalization as a bible because there are alot of quirks that can FAKE Mode Switch or be an INAPPPROPRIATE Mode Switch, but Mode Switch and Afib/Aflutter/ATach go hand in hand. If it mode switched, it's because it saw way more atrial events per every ventricular event. Whether those are TRUE atrial events and not some sensing quirks if up for the tech/rep/physician to investigate. But in either case it's indicative of SOMETHING.

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