First Pacemaker Interrogation

Just had my first pacemaker interrogation last week and have had problems with chest pain since.

The Guidant Rep asked how I felt. I said I did not have the energy I had before the PM. The Guidant Rep decided to turn on the rate response accelerometer to increase my heartrate upon physical exertion. I was told there are three settings, and I am set in the middle (not sure what the differences are) .

Since the accelerometer was turned on I have had chest pain riding my lawn tractor (PM thought I was walking I guess) , and walking short distances. Prior to having the accelerometer turned on my PM was set at 60 BPM and I had no chest pain whatsoever.....

I want to have the accelerometer turned off. any thoughts?



Probably don't need it

by MSPACER - 2007-04-29 09:04:28

You should only have the rate response turned on if you can't raise your heart rate on your own when you physically exert yourself. The rep should not have turned it on without consulting with your doctor first. You may not really need it to be turned on. Call your doctor back and set up another appointment to get another interrogation and possibly shutting it off, or turning down the sensitivity.


by randrews - 2007-04-29 10:04:35

When they put in my pm they had the response on. I didn't know that and I was scared because just walking to the car would make my bpm 100 or so. They turned it off on my first visit and and that made things much better. I had some chest pain before and some after so that was different for me. Like mspacer says if your bpm will go up on there own you may not need it.
Take care,

Rate response is tough at times

by valbob89 - 2007-04-30 01:04:13

Does that user name mean Balloon maker?

If my response helps, give a cool poodle to some little girl. If you're a balloon maker. Who makes things FROM balloons.

Anyway: First, be sure you can describe the kind of pain you're having. If it's off and on, it may not be on when you're being checked, so maybe make notes now.

I have had continuing trouble getting rate response set to meet my challenging personal responses to little flutters and fluctuations. (I can be very cranky.) But it shouldn't be giving you pain. I had trouble with my response setting when I drove on a rough road. The rep made changes several times, and I had to get used to having a bit of discomfort from the ventricle pulsing at the same time as the atrium -- or dual pulses (happens when your pulse comes during the "blanking" period of a few milliseconds during each cycle, when the pacemaker doesn't read your natural pulse because it's too close to its own signal).

Rate response works with three things: how sensitive it is to motion, how quickly it ramps up your heart rate when it senses, and how quickly (or slowly) it ramps rate down when motion ends. Getting all three to meet your needs while working around any intrinsic (your natural) pulse can be challenging. You may need the rep or your doc to work with you a few times. You may even want to ask -- after trying other settings first -- for a treadmill test to see how your heart responds on its own to the changes in demand, and changes from the pacemaker.

I have a St. Jude pacemaker with atrium and ventricle leads, and getting things set probably isn't much different from yours. You might even have fewer problems if you have only ventricular pacing.

Let us know how you do, and if you get any interesting info from the rep or doctor.

Best of luck.



by SMITTY - 2007-04-30 01:04:44

You asked for thoughts and I have a couple for you. I think you have already gotten some very good advice and I will not comment on that.

In the first place, there are many things that could be causing you to not have as much energy as before you got the PM. Some of those could be the PM settings, but mybe not too.

You don't mention the Guidant rep. getting approval from the doctor before turning on the rate response feature, If that is correct, it sounds like that with the rep. deciding that the rate response feature being activated was what you needed is a person practicing medicine. If they are not a licensed physician, that is definitely a no, no.

As for the pain you describe I had almost identical symptoms while the rate response was activated on my PM for a few weeks and I had the feature turned off afterwhich I felt much better. Of course my initial problem was not low energy level as my energy level has been so low for way too many years, and I probably would not even notice it if mine did go down a notch or two. However, the rate response did react when I was using my riding lawn mower and it hurt.

Like the others said, I think you need to see that doctor and let him/her decide why there has been a decrease in you energy level and what settings on your PM are the best for you.

I hope you can update us after your visit to the doctor as we all learn from the experiences of others.

Good luck,


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