DDD or DDDR

hi all i'm new to this group and have just had my second pacemaker fitted, old model was a DDD which i had 8 years ago (age 22 )after heart surgery for replacement heart valve( surgery left me with heart block.) never had any problems with it. the new box is a ELA rhapsody DDDR model, two days after it being fitted i had to go back and they had to turn the R mode off as it was making my heart rate a lot higher than it was compared to how it was with old model, problem is now not sure if it is making me feel light headed , pulse is fine, but don't entirely feel ok. but going back to clinic today to hopefully sort it out.does anybody have a DDDR p.m and what are the differences and advantages to it compared to a DDD model?


3 Comments

DDD vs DDDR

by SMITTY - 2009-05-28 03:05:10

Hi W9yne,

Tracey explained the meaning of 'R" and how that works. I have had my RR turned on a couple of times and I am very familiar with the competition Tracey mentions. What happens to me when there is competition created by the RR is it caused the ventricle to start contracting before the atrium was through transferring blood into the ventricle. In other words the blood was trying to flow backward and forward for a few milliseconds. This caused back pressure on the mitral valve and I had pain that felt like minor angina. They tried several times to reset the timing of the RR but never could get it right. So I simply asked that the RR be turned off.

Not having the RR is a problem for me as my heart rate does not like to go above about 85, no matter what I'm doing and that can cause me to be short of breath. However, I'll take the SOB (I got that anyway even with the RR trying to help) in place of having the RR turned on and having the pain.

I've seen a number of people tell of having problems with their RR. In fact I think I've seen more people complain about RR that I have seen praise that feature.

Good luck,

Smitty

R

by Tracey_E - 2009-05-28 06:05:12

R is for Rate Response, and if you have a block you probably don't need it turned on. It's for people with atrial problems whose rate doesn't go up normally with activity. When RR is on, the pm senses movement and raises the hr. With a block, our atrial rates are usually perfectly normal and don't need help going up with activity, so RR just competes with our natural pacing.

It's not uncommon to take a few tries to get a new one adjusted since they have new features the old ones did not. Are you feeling funny all the time or just on exertion? If on exertion, sometimes doing a stress test can tell them what's going on more so than the pm report.

DDDR model

by ElectricFrank - 2009-05-29 01:05:49

All the DDDR in the model means is that Rate Response is available. Some of the older models didn't have it.

As TraceyE said you likely don't need the Rate Response and in fact it can cause problems. When they turn it off you are in DDD mode just like your previous one.

My suggestion is to ask them to set the new pacer to the same settings as the old one. They tend to get excited about all the new features to play with and mess things up for you. I've already discussed this with my cardiologist even though I have a while before replacement.

frank

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