6 weeks post implant

The first questions

by BillH - 2017-05-07 23:18:52

There are several different types of PM and different ways that they can be used. So questions like yours can't be ask without knowing those details.

The first questions to ask about what is the dianoses. The 2nd is to aks specifically how is the PM going to be used in your case.

How looking back at your previous post you indicated that you had a RBBB heart block.

Typically a dual chamber PM would be used. With those the atria lead will be used to monitor triggers from the sinus mode.

The 2nd lead in the ventricle will monitor to see if the ventricle triggers, if not the PM will cause it to fire.

In cases like this the sinus node will triggering during exercise.

The main setting in the PM is max tracking rate.  That is maximum rate that the ventricle can follow the atria.

Often a too low default value is used for people that are active.

Questions

by TBrous&Chip - 2017-05-08 00:02:03

I started by reading the Medtronic online information including the manuals for healthcare professionals.  This gave me some idea of the capabilities of my PM and many questions for the first checkup visit.

Initially I was given a monitoring device that required me to have a landline telephone. After some reading I learned there is a monitoring device that utilizes a cell phone and a downloaded app. After asking the PM tech about this the monitoring equipment was swapped to the wireless device.  One of the features I read about, Rate Drop Response, eventually had to be activated.  It was a comfort to already understand this feature when I was told of my need and prompted questions during that visit.

Recently I had a visit to the emergency room.  The ER physician was not familiar with the model PM I have installed.  My knowledge helped the situation until the Medtronic rep arrived.  

I find that with this knowledge base the PM tech is more willing to share infornation during visits. You are your own best advocate. Know your PM settings.   Educate yourself about your PM's features.

Post 6 weeks

by Jcleg - 2017-05-08 03:04:32

Thanks guys - i also found the Learn Section on this website and that has an amazing amount of information on it. I appreciate your responses.

do your research

by dwelch - 2017-05-10 00:20:17

I got my first pacer pre-internet so had pretty much zero help, had to learn what to ask, and figure stuff out.  This site is incredible the weath of experience and knowledge.

You had your visit by now, but I always ask for my copy of the printout, last week had a new tech and different machine (just got a boston scientific had a st judes before that and medtroncis before that) so I got the full printout, the st judes box had a different/better printout in fewer pages, but whatever, its fine.  

As already mentioned, understand your condition and what the pacer is doing.  I am now three lead actually was dual for 30 years, basically the pacer is dealing with my heart block the upper and lower are not electrically connected/synced so they ran on their own (thank nature, god or whatever your preference that it keeps working at all to get me/us this far) which was bad over time.  it drives the lower chambers to sync with the upper, and if the upper goes too slow or fast there is a limit, you shouldnt be able to go beyond those.

Those are something you can just ask as well as check the printout, feeling weird, check your pulse, is it within limits (recommend a full minute not 10 seconds and multiply by 6).

They can change those settings, if after this long you simply cant sleep for example there are one or two or more things they can do (lower the lower limit, use rate response, I think some have night/day settings from reading these forums).  I know I struggled with that the first year sleeping in the 30s pre-pacer then being boosted to 60 then dropped to 50 I think to try to sleep more...

I now have a three lead which hopefully everyone here will have to deal with some day.  You hopefully have another 25-30 years before that happens though.  assuming you have a dual lead.  If you are a single chamber/lead then the pacer is probably just keeping the rythm right or within limits, your upper and lower are synced properly...