Pacemaker checkups

How often do all of you get pacemaker checkups, I am supposed to go every 6 months, which I have.  However, I do go to a teaching hospital and the checkup I got last year changed the way i felt, I started getting more AF and going back into NSR my heartrate stayed right at 80 bpm for hours and hours which made me unconfortable until I finally went back into my normal rhythm in the 60s.  This went on whenever I got an episode of AF which i got more of last winter until i complained and got an appt. with the pacer clinic and got the pacing set at 60, they had it set at 80, i don't know why they had me pacing at 80 because the only reason for the pacer was to keep my rate from falling too low when going back from AF to NSR, I have 1st. degree heart block.  After the setting was changed the first of last May I only had 1 AF event in August.  I am scheduled for a pacer checkup in a couple of weeks and I am leery about going, i just don't trust whoever is going to check my pacer as it is a teaching hospital, i will ask for a printout before and the after the checkup, keep checking my rate.  Where do all of you get your pacemakers checked at?


8 Comments

Teaching hospitals

by LondonAndy - 2018-09-30 19:55:41

So it sounds as if they set your pacemaker at 80bpm without discussing this with you? That seems like bad teaching to me, but rather than avoid them, personally I would go back to them and tell them of the issues last time and what effect it had on you, and that you want to know everything they are doing. Firstly there is every possibility you will see someone different, secondly they need to learn from their mistakes, and thirdly I bet they would be on their best behaviour with you. But good idea to get the before and after reports too.

Anyway, to answer your question: here in London they currently check my 4 year old pacemaker annually. I don't have remote monitoring. I am 100% paced, and expect the frequency of check ups to increase when the battery gets below some point.

Teaching hospital

by AgentX86 - 2018-09-30 20:23:34

I go to a teaching hospital too but they certainly don't let freshmen cardiologists work on pacemakers without supervision!  In fact, I don't see any students for my pacemaker checkups.  They aren't EPs either (nurses, I believe).

If you're having trouble with your settings, go back and get it fixed.  There is no point in feeling miserable for the next six months.  They've told me to give the new settings "some time" but that I can come back anytime I want and they'll work some more.  They are working for me.

Checkps

by Theknotguy - 2018-09-30 21:35:09

Checkups vary due to your heart problems and your Cardiologist.  I started out at every three months.  Now I'm down to a remote checkup via telephone reader once a quarter and I see the doctor once a year.  If the heart monitor flags something they'll call me in.  

I had problems with my techs.  They'd read my pacemaker and run my ventrical check up real fast.  I'd be OK for that day but would go into afib the next day.  Talked to my cardiologist and he said it couldn't happen that way.  I told him to check the records.  Don't think we ever settled who was right.  (Of course it was me.)

Talked with my tech and told him when he did the ventrical check it would hurt because they would run it up so fast.  He said they wouldn't have to do that. They'd take it easier in the future.  And that's what they did.  

If at all possible, I'd see about getting the same tech each time and tell them not to run up the ventrical check.  There is no reason for you to have pain due to a pacemaker check.  

Hope everything else is going well for you.  

Frequency of PM Check Ups, My Experience

by KonaLawrence - 2018-09-30 22:09:12

I got my PM installed last December by Kaiser Healthcare in Honolulu, nine months ago.  The "normal" schedule is to have a 30 day surgical followup, then at 6 months, then annually.  However, the Nurse Practitioner in charge of the "Device Clinic" told me to call for an appointment earlier if I needed it.

I am an amateur athlete.  After a few weeks recovery from surgery, I started back into training.  I paddle outrigger canoe competitively (yes, I live in Hawaii :-).  I practice for 1-2 hours/day 5-6 days/week.  In the summer there are races every weekend for 3 months.  I had many difficulties with high-intensity and endurance exercise.  Thanks to this website,  I read about athlete's issues with their pacemakers.  I had to go in many times to get adjustments.  They would only make one change per visit because they wanted me to see how it "felt".  I even downloaded the Medtronics manual for my PM to better understand the options (there are dozens of separate settings than can be changed!).  Finally, after seven PM Interrogation/Adjustment appointments in nine months, it's working very well for my lifestyle.   FYI, I did have one session with a technician who got confused (he said as much) and made some changes that made me feel terrible for weeks!   

Now my sleep is good, my regular daily activities are comfortable and I can workout at a steady high heart rate for over an hour, I am very satisfied.   My next appointment is a year away, but they have still told me their job is to help me have the best lifestyle possible and to call for an appointment if I have any issues.

Based on my experience, my advice is anytime you have an issue, call to get an appointment with the device technician.  When you see them, tell them, in detail, about your difficulty so the technician can interrogate your device and with your informed consent, make adjustments to some of the settings.   That is their job, to "program" the PM to fit your lifestyle.  

Good Luck, Lawrence

Knot

by AgentX86 - 2018-10-01 00:49:06

Very good points. It's also possible to change techs. The tech who comes to my cardiologist's office is only there once a week and is always booked solid. Last time I saw my EP, he had me go to one of the techs in the hospital. She spent two hours with me (with the help of a second tech, part of the time) to try to get things right. They were pretty conservative, so I may go back to try to push it a little harder.

I.like the idea of reading the manual, though. I'd like to have it cranked back a little at night. At least I could talk their language.

Medtronics Manuals

by KonaLawrence - 2018-10-01 03:20:49

Medtronics Reference guide manuals for their pacemakers are here...

http://manuals.medtronic.com/manuals/main/region

select your region, then language, then device model

They're fairly well written.  Almost understandable to a mere human like me.

Good Luck

Tickled my funnybone

by sammy - 2018-10-01 17:27:15

Just had my PM installed last week at St Vincent hospital in Indianapolis. This is a teaching hospital, so I had lots of professionals coming and going. The first day a cardiologist and two newbees (I guess either interns or residents) came into my room. The cardiologist asked if they could listen to my heart; then all three stethoscopes came down on my chest at once. Each was moving his stethoscope all over, sometimes bumping into one another.

I was thankful I wasn't getting a prostate exam.

varies

by dwelch - 2018-10-01 23:10:29

pacers for 30+ years now.  generally a visit once a year after the first year then increasing the last few estimated years (not necessarily the reported estimated life as that is not something to get worked up about until it says weeks).  

it has varied by doctors office and insurance.  I come from the phone check days.  Some docs/offices/insurance would allow for more checks per year than others.  So in the last stretch in the latter years when using the phone would be 6 month office visits and then in between phone checks.  One doc was doing monthly once as we approached the end.

I dont have one of the home boxes it is supposed to change all of this.  Im at six month intervals because I dont have a box so they tell me.  

But my advice/opinion is get your own report/printout.  The report shows a before and after.  No matter what kind of hospital, if it is a nurse/tech, a doc, a device vendor rep, etc.  If there are any before and after changes the reports typically highlight the change but you can scan the two columns visually and see anyway.  Make them explain why they made a change.  And you can voice your opinion, I dont want to have my lower limited modified, I want to sleep at night, etc.  Give me a solid reason why.  The one doc I "fired" by simply switching docs was for this reason.  Messed with my rates, refused to set them back, no explanation, game over new doc/practice.

I was asked to sign something to allow me to have the reports.  Refusing to let me have a report will push me to the next level.  My data, my body, if anyone has to sign a release it should be the hospital/doc not me.  My current EP has no issues with me getting these reports.  But I wonder what other folks experience is and suspect that there may be some resistance due to legal fears/protection.  I can no longer get my hands on old devices, I have my first few but the last one I couldnt get.  (unless I was diseased and was for religious reasons and the funeral home could take posession for burial, or my lawyer if there was a pending lawsuit, but not me)

 

 

 

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