Medtronic Adapta DR01

This is my second pacemaker. The first was Medtronic Kappa & it was perfect with right settings from the begining. It stopped working three weeks ago .I have Medtronic Adapta & have been tweaked twice & still not right.
I would like to hear from others that has Adapta & learn of their experiences.
Every once in a while I get a flutter & feel my heart beating on the left side. I never had that before with the Kappa.
Maybe the models have to many gagets to work like the other models.

9 Comments

ADAPTA ADSR01

by Rodrigues - 2009-04-20 02:04:11

Hi , I have a Medtronic Adapta ADSR01 this is my first PM , the first 5 months no problem then I started feeling flutters in my chest,when I felt my pulse I noticed skipped beats and occasionally extra beats.Today I had a electrocardiograph and all is OK and was sent home with a 24hr holter monitor to see if they can pick up this flutters that I am experiencing , my Cardio does not suspect the PM . Will keep this site informed of my findings, Cheers.
Francisco

Adapta ADDRL01

by Ivana - 2009-04-20 09:04:32

I have an Adapta ADDRL01 since January. A week after it was implanted I went to pm clinic to have it checked out because I was getting a light pulsing feeling on my left side. Is this what a flutter is?
The pulsing stopped for a while but now I feel it again almost every other day, no matter what I'm doing.

Ivana

Medrotic Adapta

by mendedheart - 2009-04-20 10:04:52

Ivana
You are correct. I call the pulse flutter can feel my heart beating on left side every so often. I never experienced this problem before. My old Kappa was perfect from the start.
I am going to ask next week at my check up. Its scary for I feel like my chest is shaking. It last a little while before leaving.
Will my findings posted. Thanks to you & Franciso for writing.
Mendedheart

Adapta MVP

by esperry - 2009-04-21 01:04:41

The Adapta model comes equipped with MVP (managed ventricular pacing). This feature allows for a couple of benefits to both the doctor and the patient. First of all, MVP reduces the battery consumption in non-dependent users (like myself).

Details: All pacemakers in non-dependent users wait for the SA node to contract the right atrium. If this fails, the pacemaker kicks in. Pacemakers in these individuals then wait for the ventricular contraction allowed by the passage of electricity to the AV node and down through the His Bundles. If at any position in this circuit the heart experiences "block," the pacemaker then paces the ventricle. This feature usually paces the ventricle 180 ms after the atrial contraction (normal P-Q interval, if you are electrocardiogram-proficient). Old pacemakers did not have the sensing capability to pace the ventricle on-demand, which means that people with these older pacemakers tend to pace the right ventricle nearly 100% of the time, even if they don't necessarily need it.

In short, MVP reduces unnecessary ventricular pacing. This feature, however, is relatively new and thus has a few issues. My Adapta ADDRL1 paces my right ventricle 74.8% of the time due to my Mobitz I heart block and transient second degree heart block. However, I only pace my right atrium 1.2% of the time, which means the MVP feature is a permanent part of my life. I experience chest flutter quite often (however, I just had my pacemaker implanted two weeks ago, so my heart is still slightly swollen). The doctor said that MVP sometimes "surprises" the heart, which causes the various chambers to contract asynchronously, symbolic of flutter.

This problem can be reduced by careful manipulation of the MVP settings on the pacemaker; however, it is likely to be a minor issue until the newer models come out.

However, all of this is said with some trepidation. Hearts have to recover after surgery; after all, the leads do "burn" tissue when they fire. While minor, there is persistent scarring until enough dead tissue has built up to regulate the immune response (swelling) in the heart. So, if you haven't had your pacemaker for more than a couple months; it could very well all settle down. At least this is what I am hoping in my case!

One more thing, there are a plethora of rhythm problems that cause hemodynamic problems as they are induced; far before the electrical signal interruptions reach the pacemaker. For example, I have Wenkebach arrhythmia in addition to other arrhythmias. This one, however, can induce chemical changes in the heart which cause you to feel funny (i.e. flutter feelings) before the rhythm centers fully react. Thus, the pacemaker is incapable of preventing these strange feelings. Luckily, though, the pacemakers stop these abnormal rhythms much faster than not having a pacemaker!

Sorry there is so much information; I have always liked to explain things to the fullest! Hope all of this helps!

sorry

by esperry - 2009-04-21 02:04:14

Sorry, I didn't mean to infer that MVP has much to do with atrial flutter. I was more interested in making the point that abnormal ventricular rhythm (which is possibly induced given the MVP feature) can induce "atrial flutter-like" feelings in the heart. These feelings can take on the likeness of atrial flutter, but they are not. Insead, these feelings are related to ventricular asynchronous rhythm.

Evidentally, there is such a thing as ventricular flutter; however the medical journals liken it to ventricular fibrillation, which is far more dangerous and is highly unlikely with a pacemaker implantation.

Flutter

by Angelie - 2009-04-21 12:04:35

Ya'll,
Flutter is a "cousin" to atrial fibrillation. Meaning that the top chambers sort of quiver at a very fast pace, while the bottom chambers pump at a slower pace.
Example:
It is rare that every flutter signal gets sent through the AV node to create the ventricular rate. The most common ratio is 2:1 atrial flutter which would be an atrial flutter rate of 300, and a ventricular rate of 150. Venticular rate is the rate that your heart pumps blood out to the body and therefore is the one that you feel when you take your pulse.

Cheer up, Frank is here

by ElectricFrank - 2009-04-21 12:04:38

I should be getting my Kappa 701 replaced in a year or so. Since everyone seems to be getting the Adapta I suppose it will be my fate as well.

So hang in there until I get mine. I'm ready to do battle as usual and expect to come up with a fix.

frank

Thanks

by ElectricFrank - 2009-04-22 11:04:10

Thanks for the explanation of MVP. It sounds like it is an improved version of the Search AV in my Kappa 701, which evaluates conduction every 16 beats. This together with Rate Adaptive AV is supposed to promote intrinsic ventricular pacing.

Your comment about the leads burning the tissue when they fire is interesting. I have noticed a relationship between ventricular pacing voltage/pulsewidth and PVC's. Last year when I had a problem with loss of capture, they set mine to 5V 1ms. This solved the capture problem, but I was showing as high as 2500 PVC's/day. I think I had some sort of virus because I ached all over, etc. When all this subsided I insisted on having the pacing energy set back down to around 2.5V 0.4ms. Within a few days the PVC's settled down to just a few. The cardiologist insisted that there was no way the pacer was causing my PVC's. I maintained the the high pacing energy could irritate the heart wall and set the scene for the PVC's.

I have nearly 100% AV block, but good sinus action.

best,

frank

Interesting

by trugman - 2010-02-07 01:02:49

I just had my second pacemaker installed.my Kappa lasted 8 years and I was very happy with it. I now have an ADSR01 and after 3 weeks I have found no problem,
After reading all the comments, I am now worried that I may develop problems,.I hope not.

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