pacemaker settings

going fast

by Tracey_E - 2023-07-19 11:09:00

The pacer is a gas pedal, not a brake. If your heart goes fast on its own, the pacer will just sit back and watch. There is an upper limit, yes, that's how high it will pace you. That can be anywhere from 120 to 220, depending on your needs. 

If it's suddenly a lot higher after a change in settings, make an appointment to be seen again. 

If your resting rate stays over 100, go to the ER. 

to going fast

by palpations - 2023-07-19 11:30:55

Thank you.

Upper pacemaker rate

by AgentX86 - 2023-07-19 11:36:55

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No, a pacemaker can only speed up the heart.  As we say, it's an accelerator not a brake. They can't solve tachycardia, only Bradycardia.

That said, they can switch to a 2:1 tracking mode (ventricles half the atrial rate) if the rate gets dangerously high. Setting it lower than 130bpm (or so), would interfere with every day life. As it is, half of 130 is 65.  Suddenly shifting, even that would be like stomping on the brake pedal.  Half 80 is 40bpm, so you cardiologist isn't going to let that happen, even if he could.

MVP shouldn't be the cause of any sort of rate increase.  <see edit, below> MVP simply puts the pacemaker in to AAI(R) mode, instead of DDD(R) mode, and monitors AV pacing. </see edit> Instead of supplying a V-pace if AV conduction is missing, it waits until some number of V-senses are lost (two of four, normally), then switches to DDD(R) mode. The idea is to limit AV pacing percentage in cases where only one pulse is skipped (out of a minimum of four). This reduces V-pacing to only what's absolutely needed.

This switch wouldn't have any significant change in heart rate.  It sounds like you have Sick Sinus Syndrome (because pacemaker is set to AAI(R) to fix Sinus Bradycardia.  Tachy-Brady (wild fluctuations in heart rate, up and down) is now a feature of your SSS.  This isn't unusual.  It's only a guess, though.  Talk to your doctor but at 80-100bpm, it's likely not a serious problem

EDIT:  BIG clarification/correction.  When I said:

"MVP simply puts the pacemaker in to AAI(R) mode, instead of DDD(R) mode",

I should have said that when MVP is selected, the pacemaker is put into AAI(R) mode, instead of the typical DDD(R) mode.

Agent x86

by palpations - 2023-07-19 12:01:09

Thank you very much for yor information.  You explained things to me that i did not understand.

pacemaker induced tachycardia

by just - 2023-07-21 11:15:44

My pacemaker is set with an upper limit of 160 -- so if my HR goes above that it is my heart doing it not the pacemaker.

BUT. . . when I was running my heart would frequently jolt up to 200 and I would have to walk and rest for a bit or it would keep spiking back up. 

The cardiologist originally thought I had tacycardia, but they kept adjusting the pacemaker settings. There is a setting for how fast the pacemaker acclerates to a higher heart rate. It took a few adjustments, but when they had it increase heart rate at a slower setting, the spikes went away. So something about the way the pacemaker was accelerating to my max -- my runs always peg at 160 for almost the entire run -- was causing these spikes.

Now when I run it can take a mile or two before I hit the 160 mark, and it rarely spikes above that.