Mode Switch/ EP visit update

So I visited with the fine EP today. Started out kind of weird because the physicians assistant came in and interrogated my pacemaker. Usually I have a nurse do it, so that was a bit odd, she was very nice though. My EP walked in the door and no joke he said "hey, how is my problem patient". Really? Dang, I guess I am his problem patient but I hadnt seen nor talked to his office for 3 month which for me is a record, but apparently he knew what was going on with all of my other health issues. I told him I have come to like my pacemaker now because it has "sank" so it is now flat with my chest.. and now on the other side I have this retarded Port A Cath that sticks out like a ball in my chest. I sure hope it sinks like my pacemaker did. Only took a year.

Anyways, we reviewed my info.. wasnt too bad. Pacing 100% in ventricle (of course), 65% in atria (which I think is a lot considering I have a fully functioning SA node). My highest atria rate was 190. We talked a lot about the mode switching after rate of 135 and the fact that it dumps my rate from 130's to 80's. Unfortunately I have a crappy pacemaker in that it allows you to set the rate of which it will mode switch and THAT IS IT!!!! How stupid is that. After that it paces at the set rate and does no sensing for what your heart actually needs. This is why I feel so crappy when I try to exert myself. It wont give me the heart rate I need to meet oxygen demand. We again debated rate response. He called and talked to his Medtronic rep about the mode switch, but basically until I upgrade I am stuck with this one. He didnt want to increase my upper rate of 125 because then I will have to deal with more inappropriate atrial tach during the day. So basically we did nothing settings why.

I am going to try and switch from Toprol to Verapamil. This was my request as I wonder if it will help with my everyday fatigue. I have had very bad results coming off of toprol in the past but I will give it a whirl and hope for the best. All in all.. pretty good visit!

6 Comments

Just curious...

by Pookie - 2010-06-02 09:06:35

What kind of Medtronic pacer do you have as I too feel crappy when I exert myself and I get short of breath.

I have an Enpulse. Dual lead. Diagnosis: SSS. and now I have Junctional Rhythm, which is A LOT better since cutting way back on caffeine.

I pace 84% in the upper chamber and always less than 1% in the ventricle.

I always had the sleep mode ON (set to 45 beats per minute from 11:45pm to 7:00am) and during that time I always paced around 64-66% in the upper chamber, but since having the sleep mode turned OFF it rose to 84% and next intterogation - I'm asking for my sleep mode back ON because in my head I feel more comfortable with pacing in the 60 % range. I know it's just a number, but......

Pookie

pacemaker

by sam78 - 2010-06-02 10:06:35

I have a Kappa - Medtronic.. doesnt have any form of sleep mode. Pretty basic pacemaker from what I am figuring out. I'm not sure I understand why there are so many different types of pacemakers.. you would think if you were going to implant one you would implant the one that can do it all, even if you just need basic pacing. My guess it is because of lack of info as I bet a lot of physicians dont know all the programming that can be done. But it sucks because I have only had mine a year and have "outgrown" it and need the next model. My pacemaker also does not transmit, so I can not do battery checks over the phone... being 100% dependant you would think that would be something they would want to check from time to time.

Something is screwy

by ElectricFrank - 2010-06-03 02:06:31

Sam,
I had a Medronic Kappa 701 for 5 years and have the technical manual for it. They are either incompetent or lying about the mode switching. I'll have to dig out the manual as far as sleep mode, but I'm pretty sure it has that as well.
This is a real common situation. Within a couple of weeks of getting mine I took a list of settings with me for a check up and hit them with it. The Medtronic rep agreed with me after I got things settled that he was to be honest with me and not just echo the cardiologist.

I have the barest minimum of pacer interference.
Upper limit 150
Lower limit 50
DDD mode (Rate response off)

Most of the time I don't even know I have it.

frank

Kappa

by sam78 - 2010-06-03 07:06:28

I only have the 400 series Frank ... not the higher up models. I am guessing if Medtronic rep says it doesnt have it.. I bet it doesnt have it. I watched them run through the screens on the interrogater too and I saw nothing as well. Each of the different series has different settings available. If you can find info about it on the 400 series let me know.

Kappa 400 series

by ElectricFrank - 2010-06-05 02:06:46

Sam,
I didn't realize you had that series. I don't have any info on them, but I agree you can certainly take the word of the Medtronic rep.

Thanks for the info. I'll file it away for the future.

By the way, how long til you will need a replacement?

frank

replacement

by sam78 - 2010-06-07 12:06:27

HAHAHA only a mear 6 years!! I just got it one year ago!

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