Pacemaker check ok, however

Received a bi-ventricular pacer in September of 2007. Reason was I had developed fatigue and breathlessness so extreme that I couldn't walk 10 yards without having to stop and rest. Quite debilitating to say the least. Electrophysiologist determined that I had developed congestive failure secondary to right ventricular decompensation.
I have done fairly well on this new device until recently...I now seem to be developing what, I can only describe as, surges in the 2nd or 3rd intercostal space and migrating up the left side of my neck. My left arm aches but does not seem to be radiating.
Pacemaker checks prove nothing adverse but the above continues to be somewhat debilitating in that I must rest for a day or so then it seems to resolve.
My cardiologist seems to relate it to stress and weight. Would appreciate any comments from anyone else who has experience such and if indeed it is stress and weight what have you done 1) to reduce stress and 2) what is a good weight loss program for the person with no willpower?

8 Comments

% Pacing Question

by SMITTY - 2010-03-15 04:03:18

Hey Pharmduk,

Can you tell us what percentages your pacemaker is pacing the atrial and ventricle?

Thnaks,

Smitty

Pacemaker check ok however

by pharmduk - 2010-03-15 04:03:45

Guess I need some education here. Have never been given percentages, I don't think per se. I do know that my pacer is set a 68 on the bottom and 110 on the top. Probably not what you are looking for.....perhaps you can give me some questions I should ask my cardiologist. I am frustrated with this feeling. It doesn't happen often, but when it does I'm down for a day or so!

Weight Loss Woe...

by qwerty - 2010-03-15 06:03:20

I am new to the PM stuff, so not much help there.
but the weightloss, I am not so new to. I have found the only diet that works.... Basically, if you want to loose weight.... While you are eating... if it tastes good... spit it out! because you know it is going directly on the hips.

Good luck!

Percentage Pacing

by pharmduk - 2010-03-15 07:03:00

And what does the percentage pacing indicate? Is this something that can be adjusted? Is this something that perhaps goes un-noticed unless I am aware?
My cardiologist just called and indicated that he wanted to place me back on a beta-blocker (sotalol). He states that he feels a predominate amount of my issues may, in fact, be stress related. Can Stress cause pacer discrepancies?

weight loss

by JessiWay - 2010-03-15 07:03:19

I have found that eating well & exercising work miracles in the weight loss department. Cut down fat & sugar & walk a few times a week. Ask your doctor for a copy of the interrogation report that they printed when they did your last PM check. That will show the percentage you are pacing, which is what Smitty asked for. If you post the interrogation report people will be able to help you decipher it. Good luck & try to keep a positive perspective...it makes a huge difference! Take care!
Jessi

Percentages

by SMITTY - 2010-03-15 08:03:58

Hi Pharmduk,

I asked the questions so I'll try to answer your questions. I must warn you that most of my answers are based on very little knowledge and a lot of guessing.

In a round about way I'll try to answer your question "what does the percentage pacing indicate?" With an on demand pacemaker, which is what most of us have, the PM sends impulses to make our heart beat only when it detects the heart's natural pacemaker has not done so. The catch to that is a lot depends on what the settings are on your PM. Lets' take mine for example. My settings are low-80, high-120. When my heart rate drops below 80 my PM will step in and send the necessary impulses to keep my HR at 80. Or, say I have been doing something that has my heart rate above 80. My manmade PM will just be a heart function monitor, however, should the heart's natural PM fail to send an impulse then, even though my HR is above 80, my PM will send an impulse to replace the one that the heart's PM did not send. This will continue until my HR exceeds 120, at which time my PM just becomes a monitor and waits until my HR drops back into the range (80 to 129) where it should be helping before sending any impulses it thinks is needed.

My normal HR (without help from the PM) is in the mid-60s range, Because of this and my PM settings, my PM is pacing my atrial more than 90% of the time and ventricle 3%+ of the time. Why the difference in percentages I do not know, except to say the ventricle does not need help as often the atrial. The printouts made during my PM checkups show these percentages and since I get copies of these I am able to see if there are any changes. Prior to July '09 the low setting on my PM was 70 and the percentages pacing were about 6% for the atrial and 1%+ for the ventricle. So as you see the settings cause variances the percentages.

To answer your question "Is this something that can be adjusted?" I have to say possibly yes and no. With fixed PM settings the percentages can possibly be changed a little by varying the timing of some settings. However, to me the most likely way of adjustment is changeling the low and high settings as was done on my PM.

For your next question "Is this something that perhaps goes un-noticed unless I am aware?" my answer is absolutely and that is the way it should be. I think it is not necessary for us to be aware of every time our PM helps our heart beat.

To answer your last question "Can Stress cause pacer discrepancies?" I have to say no stress will not cause pacer discrepancies. However, stress can cause changes in our heart function and the help the PM provides for your heart could be altered by this stress. So in an indirect way I guess it can be said yes stress can affect pacer operation.

Smitty

Pacemaker check ok (continued)

by pharmduk - 2010-03-15 09:03:52

Thnnks for the feedback Smitty. I am now pacemaker dependent. This means should my pacemaker fail, then there is apparently no recovery pace. I had AV ablation so have no signal going to the SA outside of the Pacer signal. Not to bright when it comes to what this really means but know I am not real comfortable if it doesn't seem to working correctly. I may be more apprehensive than necessary, not sure!

PM Dependant

by SMITTY - 2010-03-15 10:03:14

Pharmduk,

Talk to your doctor about this, but things may not be quite as bleak as they seem right now. Our heart has what I'm going to call a backup pacemaker for last resort situations. If I understand it correctly, heart beats from this PM originate in the left ventricle and can sustain life for some amount of time.

Also, I have been led to believe that there are ablations and then there are ablations. In other words some leave a person more dependant on their pacemaker than others. So even if your are considered pacemaker dependant that could mean that to have an acceptable quality of life you must have your pacemaker. But until your doctor tells you that without that pacemaker functioning as it should it is the end of the line for you I would not assume that.

So again, talk to your doctor about your situation and find out if your pacemaker functioning truly means life or death for you or does it just mean an acceptable quality of life.

Good luck,

Smitty

You know you're wired when...

Your favorite poem is “Ode to a Cardiac Node”.

Member Quotes

Your heart’s electrical system has a manmade helper. A helper that only knows to do what it is programmed to do and will perform that function day in and day out, without fail. Now, go enjoy your new grip on life.