Settings and adjustments for arrhythmias
I have a Medtronic Ensura dual chamber pacemaker for tachycardia/bradycardia syndrome (implanted in 2018). A few days ago I returned to my clinic and they looked at NCAP (non competitive atrial pacing) and APP (atrial preference pacing).
I was told NCAP helps prevent atrial tachy arrhythmias by avoiding (delaying) pacing after a premature atrial contraction (PAC)
APP helps prevent atrial tachy arrhythmias by overdrive pacing after a PAC which can help stabilise and maintain consistency in atrial activation.
My EP arranged for me to have NCAP switched OFF to see whether overdrive pacing provided by APP might work more effectively on its own to stabilise any PACs which are a known trigger for my Atrial Fibrillation (AF). So far the results have been really encouraging.
During my check, the technician picked up some under-sensing of my AF on one of my stored atrial electrograms during a long episode on the 4th February. This was concerning although not altogether surprising. The technician therefore adjusted my "atrial sensitivity” to the highest level, from 0.30 mV to 0.15 mV (where the lower the number = the more sensitive the pacemaker).
I was told my Mode Switch (which is a feature on most pacemakers to prevent the tracking of a fast arrhythmia) should work better too with the atrial sensitivity level set higher (although probably means more Mode Switches).
When I joined the PM Club I was always reading how important fine tuning of settings were to get the most out of our pacemakers to suit our lifestyle. It has taken me almost 5 years to get any real changes made to my current Settings but I am happy it is finally happening, albeit with some scepticism that I can work wonders on my arrhythmias with my pacemaker alone. But why shouldn’t I at least try to optimise my Settings, to make them work better for me?
While I accept the limitations of my pacemaker to treat an arrhythmia like AF, there is no harm in asking our EP’s what more our pacemakers can do for us. It is an amazing little device and in my opinion, often under utilised. Good luck to everyone battling with an arrhythmia like AF, although I am sure you will have some pacing success stories too?
You know you're wired when...
You run like the bionic man.
I wasn't really self-conscious about it. I didn't even know I had one until around six or seven years old. I just thought I had a rock in my side.