St. Jude device check

A week ago I had a very strange visit in my cardiology office.  I questioned to myself that it had been scheduled on-line without consulting me but I see this group so infrequently that I assumed it was routine and it was not.  5 1/2 weeks after my nighttime device check I was summoned to their office to be told from their device technicians that there was something wrong with my pc.  If I had known this was not routine I would have asked someone to go with me to be "my ears" because of my hearing loss.  The experience has left me with a sense of total communications break down.  Because I wanted to walk away with some understanding of the issue I asked them to write it down.  I have a post-it note that says *changed lower rate to 80 bpm; *made adjustments to atrial sensivity; *changed mode to DDDR.  Evidently my pc lead was reading noise reversion signals incorrectly. 

My visit took an hour for the many adjustments they made and possibly because something they did made me light headed.  The technicians were very kind although they could not answer my questions; therefore I have an appointment with the NP in October.  By October it will have been 9 1/2 weeks since my pc developed this problem without answers and unsatisfying communication.  I do  trust that after an hour in the office the problem was corrected for now but......lack of communications generates extreme uncertainity.

I just don't know what to do next.  Should I be concerned?  Advice and encouragement are welcomed.  Thank you.  I don't understand these terms and how they apply to me.  I've had my pc since March '17, a-fib my problem and I am doing fine or so I thought.  Thanks again!


I'm Impressed

by Swangirl - 2020-09-03 13:49:29

Hi Dorothy!  I understand how confusing and disconcerting it was to be scheduled for a device check that wasn't routine especially with your hearing problem and the difficulty in communicating with the technicians.  However, I am impressed that someone picked up the problem from your night monitor and followed through with contacting you and spending a good hour correcting it.  That gives me much more confidence in our device monitoring system.  The monitor is working and obviously there's a live person somewhere who was contacted.  I feel safer hearing your story.  It sounds like you are in good hands.  

As far as he problem, I am not a medical person, and cannot tell from your description what was corrected.  I trust that others on this site will respond if they can help you further.  


by dorothy45ks - 2020-09-03 13:55:57

Thank you Swangirl.

Likely all routine

by AgentX86 - 2020-09-03 14:11:17

The only thing you've said, above, that is at all concerning is the noise on the atrial lead. They corrected this by making it more sensitive. Noise isn't good but it's not something to get upset about. Everything else is absolutely normal.

They've likely detected some Afib, PACs, PVCs or some other begnign arrhythmia and increased your heart rate to try to "outpace" it. This isn't normally successful but it's completely noninvasive, so worth a try.

Changing mode to DDDR is also normal, depending on exactly why you need a pacemaker. It just means that both the atrial an ventricular leads listen before pacing and that either can pace their respective chambers  if need be.  The 'R' at the end means that "rate response" is turned on. This varies the pulse-ox rate according to some algorithm, based on physical measurements, rather than having the heart do its own thing. This is also "normal for those of us who's heart doesn't do the right thing on its own.

In short, there is absolutely nothing to worry about. Your being called in to the device clinic is a bit unusual, in that normally an appointment is set up when the pacemaker is implanted. Changes almost always have to be made after a month or so. Often they will plan to make changes. In my case  they started with the heart at a faster rate because it's been shown that there was an elevated incidence of SCA right after my sort of surgery. After a month it could be dialed back (and again, a month after that). Appointments were made for there events.  Also, I could and did make appointments is anything was wrong or if I felt I needed "tweaks" to my pacemaker settings.

In short, there isn't anything to worry about. Everything they did is a normal part of life with a pacemaker.

making changes

by Tracey_E - 2020-09-03 14:18:26

They can talk to us and read what the pacer is doing remotely, but we have to be there in person in order to make changes to the settings. It's common to make changes to the settings, particularly if they picked up noise on a lead. Noise happens, it can mean the lead is starting to show some wear,  scar tissue is building up, our needs have changed, or a bunch of other perfectly routine things that can be fixed by reprogramming. I'm no expert, but it doesn't sound worrying to me. If it would make you feel better, ask for a telephonic appointment when you can have someone with you and have them explain it better. 

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