Heart Rate

An excerpt from my recent PM optimization report: "

Other Findings:   Due to ventricular ectopy and restrictive diastolic filling heart rate was increased to 85 with a slight reduction of LV OT integral. Increasing left ventricle first to the maximum allowable setting demonstrated a slight reduction in mitral regurgitation with an apparent increase in ejection fraction. The LVOT integralincreased to 14.7 from 12.7.

Impression: Pacemaker optimization performed with an apparent improvement in ejection fraction from 15-20% to 32% with reduction of moderate to severe mitral regurgitation to mild to moderate. Ventricular ectopy was still noted at a heart rate of 85. The patient could benefit with further reduction of ventricular ectopy."

At my more recent device clinic appt., the nurse raised her eyebrows at that heart rate of 85 and questioned the need for that high a rate.

Should I continue down the road of questioning my EP (a Doc who did not perform the optimization) but appears to condone this rate?

BTW: My current typical BP is usually in the 95/56 range



Heart rate

by AgentX86 - 2019-04-30 12:55:27

Your EP knows more about your needs than anyone here but I want an explanation for anything that I think is unusual.  Any doctor, particularly a specialist, owes his patient an education about his condition and any treatments. This is the basis of informed consent, which is the foundation of our healthcare system.

heart rate

by lachalupa - 2019-05-08 15:31:03

I have had many optimization therapies. It increased my EF 10-15% and I was able to do things I was never able to do before. My rate was also increased to 85 and I loved it. My medtronic tech who had programmed me for years felt that this was the best rate and the most optimal benefit to my heart. It wasn't until the other day that a new EP tech decreased my rate to 75. I haven't been happy at this rate, but my new Dr. wants to keep it here. My EF is unchanged with this change but I can't do the activities I am used to doing. 

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Sometimes a device must be tuned a few times before it is right. My cardiologist said it is like fine tuning a car.