Programming effect on battery

Since I have a dual lead PM, my checkups are every six months. During those checkups the programmer technician exercices my heart through the PM. She says, "now you are going to feel something". And I feel some thumping in my heart. I understand that this cannot be done over the phone and requires the programmer to be present (in case of difficulties). They place the programming head right over the PM site to do this. Also they do an ECG and download the episode history, impedance, voltage, histograms, etc. All that stuff CAN be done over the phone, I believe. It's just the thumping that you have to have done personally.
Here's my question for anyone out there who is a PM technician or maybe ElectricFrank. At the rate of one thumping every six months, a process that definitly uses PM battery, how much of the battery life is depleted over a five year period? Or, if they didn't do the thumping, how much more life could I get out of my battery over a five or even a ten year period? I can understand all the downloads being necessary but if your leads are good as impedance and voltage readings indicate, why do they have to thump me? They say they are 'testing' lead pacing. Hey, they just downloaded a bunch of info that tells them what percentage of AV I'm being paced! I say they are shortening my battery life unnecessarily because of a protocol set up by some PM manufacturer for their benefit, not mine.
If I'm all wet, feel free to scold me. I just want to find out what is going on.

5 Comments

Battery Consumption During Checkups

by SMITTY - 2011-01-04 02:01:26

Hello,

Let's take a look at your question from the math angle.

Say the battery will last 5 years. Then 5 X 365 X 1,440 min/day = 2,628,000 minutes of normal battery life. You have a checkup every 6 mo. which lasts 15 minutes. 2/yr X 15 X 5 yrs. = 150 min. If the power increase to give the thumping is increased for the full 15 min each time that will total 150 min over the 5 yr. period.

Now let's apply those figures to the V readings I can get from the printout of my PM checkup. In the last month of the battery life the battery voltage was reported to be 2.73 V. My power setting was 2.43 V. During that checkup I went through the usual thumping when the power setting was increased. While I don't know how much the V is increased, It could not have been more than 0.3 V. (2.73 - 2.43) to make me feel the thumping. Although the thumping never lasted for the full 15 min let's say it did. That would mean the increased power setting was for 150 min of the 2,628,000 min of 5 years of expected life. That amounts to 0.00006% or about 158 min (2 hr 38 min) out of the 5 yr life of a battery.

If my math is correct, or realistic, I think we can discount the time we spend feeling the thumping and knowing it is caused by an increase in PM battery usage.

Smitty

snith & Smitty

by agelbert - 2011-01-04 06:01:34

Thank you for the information and advice. I'm sorry if I sounded accusatory of Medtronic. It was not my intention. I also do not wish to second guess health care professionals.
I just want to be as informed and involved in the decisions concerning my PM as possible.

Add

by golden_snitch - 2011-01-04 07:01:29

The protocol for pacer interrogations is not set up by the manufacturer. There are guidelines published by societies like the American Heart Association, European Society of Cardiology and so on. These guidelines are agreed upon by working groups consisting of cardiologists/EPs.
Also, yes, there are information that can be obtained by pacer phone checks but there are no settings that can be CHANGED during such a phone check. And of course, the cardio does not change settings according to information gathered from a pacer phone check weeks or months ago. Before settings are changed, he/she always obtains the latest readings, and then makes adjustments, if necessary. Lots of re-programming is actually done in order to prolong battery life.
The pacer manufacturers are working on the longevity of pacer batteries - and they have to because the more surgeries a patient needs to replace a pacer, the higher the costs get for insurance companies (and, in the US, for you). I bet no insurance company would pay for pacer check-ups that "waste" battery life.
Think about it.

Threshold testing

by golden_snitch - 2011-01-04 07:01:55

When they are "thumping" you, they are testing the atrial and ventricular pacing threshold, and this can actually lead to a longer battery life! If the threshold changes, the output voltage needs to change, too. With a higher threshold - for example due to scar tissue building up -, the impulse the pacer gives needs to be stronger, otherwise your pacers fails to "make your heart beat"; when the threshold decreases as this is usually the case a couple of months after the implant, the output can be decreased, too, thus prolonging battery life.
So, be careful with making such accusations. There is to my knowledge absolutely no test during pacer interrogations that "wastes" battery life.
Inga

Questions are how we test our understanding

by crustyg - 2019-04-11 12:32:23

I am not sure that asking a question is necessarily an accusation.  Yes, the question may reveal some of the questioner's thinking, but thinking someone's motives (the tech or manufacturer) aren't entirely pure and actually coming out and saying so - an accusation - aren't the same thing.

I ask lots of questions, and my poor physician politely and courteously answers them - even the 'stupid' ones.  He's a saint - but then he has to be to put up with me!

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