Problems post battery change

Hello again..

I posted earlier that I was having issues since getting my device replaced. Home monitor not showing anything and the ecg monitor I had for a week just showed my usually problems of inappropriate increase in HR when I'm exercising. The technician did another couple of adjustments to try and modifythe blocking out at my upper limit. 
unfortunately I'm still getting a strong pulse feeling under my lower left ribs,and there isn't any obvious reason for this. Happens when I'm exercising and feeling that I'm maxing out but also occasionally when just stitting. Getting an x ray to check leads even though it's highly unlikely anything has moved. 
Can the procedure of changing devices trigger some kind of change within the heart? I really can't think why or how but it's so frustrating and I feel like I'm back to six years ago. Hate feeling sorry for myself but I've been surprised at how upset I feel, as the last few paddles have been a struggle as the conditions have been a bit challenging but nothing that I've managed before. I had learnt to pace myself and my pals have been really great. 
To be fair Im fine the rest of the time so can't really complain too much. 


Problems post battery change

by Gemita - 2022-11-30 05:50:46

Dear Jane, 

I can imagine your disappointment with your new device and the frustration of hearing that your monitoring does not show anything of major concern to account for your continuing symptoms, apart from an inappropriate increase in HR when exercising.  I note that you have a complex arrhythmia history and as an arrhythmia sufferer myself, I know only too well that these can be triggered at any time and may not always be identified or reported on during routine pacemaker monitoring since our doctors will set the parameters (the heart rate and the duration) at which they want these to be recorded.  If our heart rate or duration of the arrhythmia do not meet the criteria set up by our doctors for their storage and recording, then the arrhythmia will not be recorded, despite our symptoms.  This leaves us scratching our heads, I well know, which is why longer term monitoring with an external holter monitor or a Zio patch may be beneficial (and longer than 7 days).  External monitoring will report on ectopics or any arrhythmias which do not meet the parameters set up in our pacemakers for their recording and storage.

You ask “can the procedure of changing devices trigger some kind of change within the heart”?   Unless you had a completely new pacing system, with new leads attached for the first time to heart muscle tissue, or an additional lead which needed to embed in and they might therefore have set lead pressures slightly higher initially while this process took place, then I see no reason why a simple device change (new device only being attached to old leads alone) would cause your symptoms.  However I see you changed from a St. Jude to a Biotronik pacemaker.  Are you still using St. Jude’s leads and are they compatible, or was it a completely new system?

Jane it is so difficult to know what has happened.  A new pacing system or an upgrade with an additional lead could well change your pacing performance and any settings adjustments need to be done slowly, so that you and your doctors know what works and what doesn’t.  Don’t go rushing in and change too many settings at once is my best advice and make sure that you work on a treadmill with perhaps a representative from Biotronik who will know the device best (or take him kayaking with you to see what happens to you during these symptomatic periods)!   Clearly they have identified some pacing problems which they haven’t completely resolved and until they optimise your settings, you may continue to have symptoms.

The diaphragm pacing (?stimulation) sounds to me like a too high setting from one of your leads.  Are you pacing Bipolar or Unipolar because that could make a big difference too.  Most are paced Bipolar.  Anyway, ask about this, and also about lowering lead output if this has been set higher for some reason?

It may be that you need to remain patient for just a little longer and not to expect a complete resolve of “all” your symptoms overnight since settings take time to optimise.  Continue to work on the treadmill with a good technician/Biotronik representative so that they can see what “actually” happens when you reach your upper heart rate setting.  Only by witnessing this, will they truly understand.  I hope your symptoms resolve and that you will stay in touch and let us know when the final diagnosis is known and a solution is found? 

Thank you

by Jane S - 2022-11-30 06:44:04

Gemita, thank you for your reply. 
The leads are the original but are compatible to my new device. 
settings are the same as before in terms of out put ( I'm not sure of exact values.) I did have a monitor for a week which showed my increase in HR when exercising but didn't show much else. 
The technician is speaking with my cardiologist so we will see if he has any thoughts. I can't complain re the help/ support I'm getting but maybe as you say new devices have so many new algorhythms built in that atapting them can take a while. We are leaving things until January ( unless I feel bad) then have a chat  

You are so right in trying to be patient, I do get a bit over whelmed with frustration at times.I think as you get older you don't want to waste time.

Thanks so much again Jx


It’s ok

by Lavender - 2022-11-30 09:56:05

It's perfectly fine to have the occasional bout of self pity. Why do we feel guilty about that? Gosh we are quick to encourage others when they're down, why are we such harsh taskmasters on ourselves?

You have pals and a good medical team. You need to reinforce your inner cheerleader. You're worthy. You deserve to feel what you feel. Go through it to get to the other side. Be good to yourself!

Hey-how about going to get a nice massage? A bouquet? A favorite beverage? One perfectly crafted goodie from the store? How about a treat of something just for you? A reward for your suffering, like you would bring a friend when they're in need of a boost! Some new camping or hiking gear? Aw c'mon you know what you want!😁


You know you're wired when...

You have a dymo-powered bike.

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A pacemaker suddenly quitting is no more likely to happen than you are to be struck by lightening.