First post implant appointment

 

I had my PM implanted in January and now I am coming up on my first in-person visit (Monday) with both my cardiologist and EP. I’ve talked with them since the implant and while I thought my PM was set to VVIR, in fact it is set to VVI. So, changing to VVIR is one of the things that will probably be changed.

The reason for the change is once I got the OK, I started on a treadmill and eventually water aerobics. At first, I was doing fine. Felt great all the time. Then after about a week I started getting winded and more tired after the exercise. I can last the remainder of the day. From what I can tell using my Fitbit, my heart rate doesn’t increase. This is the reason for turning on the rate response.

The question I have is are there any other settings I need to pay attention to? My PM is currently set for a rate of 80. Not sure what range they will set it to once the rate response is turned on. I haven’t been active for over 10 years due to a multitude of health issues. I feel the PM has given me a new lease on life and I wanted to take advantage of it the best I can. I know I will never run a marathon.

 


5 Comments

How to Deal with the Cardiologist for Calibrating your Pacemaker

by RAVI - 2023-04-07 22:05:35

Hi - I had my pacemaker implant done in April 2022 ( last Year ) and it took about 4  to 5 sittings over a 2 - 3 month period for the Technicians and the Cardiologist to calibrate the correct settings for me. So the best is to tell your Doctor the entire problem and he will work with the Technician and calibrate the machine. In India - you can fix up appointments ( paid ) within a week - I would also suggest that you write a short note of less than a page and give it to your Doctor instead of having to orally give him all the details because he can make his recommendations on your note itself and it is helpful for him . Hope all goes fine for you.

VVI/VVIR

by AgentX86 - 2023-04-08 00:18:30

Wow!  You two have been through the ringer!

I too have had an A/V ablation but have a CRT pacemaker set to VVIR(V) mode. I don't know why they didn't set it to VVIR mode right out of the gate but, yes, you should have rate response turned on (or understand why not). 

It might take a little while to get it tuned in but it'll be better than it is now. I still have trouble where I need more oxygen than I would need just by walking.  I have mine set to increase rate as fast as possible but it still comes up short for stairs and such.

 

Success Story?

by Gemita - 2023-04-08 06:08:10

Aristocat, it was a joy to read your post and to know that you feel your PM has given you a new lease of life.  I am sure you will soon be able to enjoy some of your favourite activities once you are well healed, time permitting of course.

I would go to your next appointment with a list of any symptoms that might concern you, rather than focus on which settings to ask about with the exception of Rate Response of course.  My doctors are usually less interested in my technical questions (of which I know precious little) but want to hear more about “how I feel and whether I have any troublesome symptoms like breathlessness, fatigue, chest pain, dizziness".  Based on my answers, they usually know which settings need adjusting, whether a review of my medication is required or whether any further monitoring of my heart is needed to help guide therapy.

This is the beginning of a long journey for you and in my experience our doctors usually like to wait a few months to see how our hearts settle down to pacing first and whether our current settings are right for us before changing anything.  To change settings too early could cause problems too, so a wait and see policy is not always a bad thing.  It took my heart three months to settle/heal. 

I see from your extensive Bio information (thank you so much for doing this) that you have a significant medical history and are the primary caregiver for your wife who has had multiple strokes.  I am very sorry to hear about this and do hope that you both still have some quality of life "together".  I hope you are able to take good care of yourself too sometimes, since from personal experience I know how difficult caring for a loved one with complex health issues can be. 

I send my warmest wishes to you and to your wife and hope that you will have a very useful first in-person visit on Monday.  Please come back and let us know how it went.  

Thank you

by Aristocat - 2023-04-09 12:04:48

Thank you all for your responses. I see the wisdom in what you are saying. I'm a "geek" and think of the technical aspect first. You've brought me back to where I should be.

Geek

by AgentX86 - 2023-04-09 16:40:26

There is nothing wrong with being a geek (who, me?).  Reading and understand the manual on your pacemaker can give you an insight into how it works and what's possible.  However, the devices are intended to cover a number of different electrical problems so many of the settings aren't relevant to you. 

Understanding how it works and how you work, or don't, can be useful when talking to your cardiologist.  Don't look at it as telling your doctors what to do but understanding what they are doing.  It will also give you a baseline from which to ask questions.  You'll probably find that if you're informed about your situation, your doctors will be more willing to spend the time to educate you further.  Most can't spend the time to learn or to ask questions so there really isn't a reason to spend a lot of time with them.  However, if you show interest, it's human nature to talk about your specialty.  You'll get more, better, face time with your doctor(s).

Again, don't tell them thier business.  It's bad form.  Rather, ask about your situation and about your treatment. 

You know you're wired when...

Your signature looks like an EKG.

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