quarterly transmission

My quartely transmission was on Dec 19,2023.  Here is the summary. There were 229 atrial high rate episodes detected.  Most were at rest only 6 while active and on Nov 25, which was day i cooked for 5 of us.  The longest lasted 0:00:54:52 in duration.  There was a 1.8% cumulative atrial arrtyhthia burden which was much less the last quarter of 11%.  Review of EGMS shows AT/AF. 1 ventricular high rate episode detected.  Review   of EGM show nsVT13 beats.  Health trends do not demonstrate significant abnormality.

  Battery llife left 8.9 years. Percent paced RA:61.69   Percent paced RV63.48.

new to pace


6 Comments

Improved results !

by Gemita - 2023-12-20 18:47:28

Hello New to Pace, thank you for the quarterly transmission results.

I know we would both like to see 0% time spent in AF (AF burden) but the improvement since last quarter is there for all to see.  That is extremely encouraging especially since you have had so many other health concerns and painful symptoms to contend with and I would have expected a much higher AF burden. 

It seems your episodes have mostly been short lived and this is reflected in the lower percentage burden of only 1.8% as compared with 11% last quarter.

That is a healthy battery life still remaining.   I see you are pacing equally in the right atrium/right ventricle.

The only observation I would like to make is that your right ventricular pacing % seems quite high.  I think we have the same heart condition.  I am only pacing 2% of the time in the RV (right ventricle).  I see you have MVP (managed ventricular pacing) setting turned on from a document you kindly provided in the past.  This setting helps to prevent unnecessary RV pacing.

I also note on this document that under Observations that the RV capture management, actual safety margin is quoted as being 2.7 times more than the programmed margin of 1.5.  I did mention this in your June message, see link below.  Did you ever ask your doctor what this meant and whether any changes to your settings needed to be made?  A high percentage of RV pacing may increase our risk of increased AF in the long term.  

Overall though, I would be extremely happy with those results.  Really good news

https://www.pacemakerclub.com/message/43348/quarterly-remote-transmission-results-june-202023

results

by new to pace.... - 2023-12-20 19:00:01

Thanks , Gemita for your thoughtful comments.  I will see the cardiolgist in March for my yearly checkup.  Will ask those questions of her then. Also it will just after March's quartely transmission.  So will have new numbers for her.

The right ventrical is  lower by a almost a percentage point from the previous quarter.

I noticed in my log events that i had many on Nov 25th where i cooked for 5 of us.  A somewhat stress full time. 

Wonder if the occasional pain,or the disc crunching, i am having in my spine could be the cause of some AF episode.?

new to pace

Atrial Fibrillation (AF)

by Gemita - 2023-12-21 03:11:47

New to Pace, whenever I have another health condition that is severe enough to cause pain, I can certainly get an increase in all my arrhythmias, including AF.  You clearly have active “diagnosed” spinal problems so the disc crunching sound you hear is no doubt related to this and to the wear and tear in your spine.

I can however get chest and upper back pain when I am in AF because of the irregularity and speed of this arrhythmia.  Blood flow during this arrhythmia is most definitely sub-optimal because of the quivering atria during an AF episode which causes a decrease in cardiac output.  My related chest/upper back pain usually stops on cessation of AF.  

Yes stress can certainly be a factor in triggering AF and so can what we eat or drink, so may I ask what you had to eat/drink on the 25th November?  

Yes I noticed your percentage pacing in the right ventricle was slightly down from last time, but unless you are getting heart block or conduction delays, or your pacing requirements/settings have changed for some other reason, I cannot understand why you are pacing so much in the right ventricle?  It would definitely be worth asking your doctor about the significance of this, since I see your main mode of pacing is atrial (AAI mode) for Sick Sinus Syndrome like me.   

I had roughly the same level of AF burden at high atrial rates as you last quarter, but with only up to 2% ventricular pacing.  Your detection rate for Mode Switch (162 bpm) for high atrial rate episodes is set lower than mine (171 bpm) and I see some of your other settings are different too.

Since you are not on any meds like a beta blocker that could slow conduction through your AV Node, I wonder if your heart condition has changed and whether you are getting any heart block causing an increase in right ventricular pacing?  Worth asking about.  Also, when did you last have an echocardiogram and do you know what your ejection fraction is?  I would want to keep an eye on this with a high percentage of right ventricular pacing and AF

Hope you have a happy AF free Christmas New to Pace.

reactions

by new to pace.... - 2023-12-21 08:41:25

I was just going to add some more comments.  So thank you Gemtia.  On Nov. 25 where most of the recorded times were between noon and 2pm.  I was providing lunch to 5 of us.  The "active" times were when i was (moving) and greeting the gals and animated conversations.  The "rest" time was seated  or standing and eating and other conversations.

Have tried to have less food reactions which i know are triggers for me. Some days i do better than others.

The report mentions for the AT/AF the"avg bpm A/V is around 250-350 of course some near 382, but they are short bursts.

I looked on my report there is no mention of "ejection fraction".

Does show dection rates of AT/AF of >162bpm and VT of >150..  Under Therapies mentions All Rx Off..

Expect to see on the next quartly in March for Dec 24th more high epsiodes as am having a lunch for 7 of us.  The reason  not on the 25th as the weather here mentions rain.

Do not know if the cardiogist in March will schedule and Echo.

Will be starting a new thread on more of this subject.  As i have questions.

new to pace 

High atrial rates

by Gemita - 2023-12-21 12:00:36

New to Pace when you mention atrial rates in the 350 bpm+ range, it sounds frightening, doesn't it, but atrial rates for Flutter and AF can often exceed these numbers.  Like you, my episodes now are short lived, but they never used to be which is why I became so unstable.

Of course mode switch usually takes care of fast AF by switching to a non atrial tracking mode until the high heart rate episode is over.  Without mode switch and a pacemaker, we would still be helped by the AV Node which naturally slows conduction to allow the atria to pump blood into the ventricles before they contract.  AF with a rapid ventricular response rate is dangerous though and needs controlling.

No your quarterly transmissions report wouldn't show the ejection fraction.  That would be on your last echocardiogram, if you can recall when one was last done, or it may be mentioned in correspondence from your doctors.

results

by new to pace.... - 2023-12-21 15:54:15

Thanks again Gemita for your knowledge and questions.  First for Thanksgiving i made sure not to eat my sensitve foods, as did not want to fall asleep or be sluggish.  An of course i do not drink alcohol.  So it had to be the excitement of being with others.

The last Echo that i had was July 2021,do not have  the results  of that. Nothing in my online history. Guess am due for another will ask the doctor, when i see her.   But  before 2019 was having one yearly at my annual physical GP visit.  One time the gal was taking longer than usual.  I asked why, she said the previous year showed fluid around my heart and this time none.

new to pace
 

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