Thanks and technical advice needed

First of all I wanted to say thanks to all of you who gave me advice 3 weeks ago about having my first pacemaker fitted. It was great to hear from people who have had real experience of them, rather than the medical staff who just tell you what to expect. Anyway I had it fitted so now I can join you as a fully fledged member.

It's been 3 weeks now and I'm still ever so stiff and have lots of muscular pain. Probably overdoing it, as I have 2 young children and am still cleaning, cooking and running round like a mad person as I usually do. They told me to live life as normal when I left the hospital, but am begining to wonder if that was for somebody who lives a life that is usually slightly more sedate than mine!!

Now for my question? My heart rate usually sits about 45 and often drops down to about 35, with regular intervals are complete heart block, though I am mainly asymptomatic. Initially they left it at factory settings, which meant I was pacind permanently and I felt awful so they turned it off, my heart was racing and I was getting palipitations. I was a bit angry as they had said it would only work on back-up, to prolong the battery. Anyway so then turned it off and set it on back up, only to kick in if it went below 40 and I felt fine just as I did before the operation ( I wasn't really having any problems or symptons). My consultant then called me back in as he felt he wasn't offering me enough from the pacemaker, he wanted to try and help my heart function as normal as it was completly unsychronised and try to cure the breathlessness and troubles I had with cardiac vascular exercise. However, they have discovered that I have an unusually long PR Interval(??) outside the settings of the rate response(?), so it wouldn't work for me without permanently pacing. So instead they've changed the settings to let me miss 1 in 4 beats, but kick in if I miss 2 in 4 beats. Hope this makes sense? Think I'm in DDD mode?

For a few days I felt fine when I wasn't doing too much. But went back to work yesterday and feel like my heart is still a bit sensitive and over excitable to the pacemaker. My heart seems to race and I get palpitations and breathless, after a just a short walk or a coffee. I climbed a short flight of stairs and my heart rate went up to 130, I'm only 34, fairly slim, fit and don't smoke, but am beginning to feel like I'm a lot older and out of shape. Do you think this is the settings or perhaps I just need to get used to permanent pacing, which is something I didn't want to get used to as I was asymptomatic.

I'm going back to see the technicians tomorrow and don't want to flumoxed by technical spiel again. So any advice much appreciated.

Thanks in advance.

Eve x


1 Comments

Something fishy

by ElectricFrank - 2009-08-27 02:08:03

If you have the information correct it would indicate that whoever is making the decisions about your settings is incompetent and flailing around in the dark.

The DDD mode sounds like you have AV Block which is a simple mode that senses your atrium and uses it to pace your ventricles. The settings that are important are:

Atrial Sensing Voltage
Ventricle Pacing Voltage
These determine the pacermakers ability to handle your heart.

Ventricle Upper Pacing Limit: around 140-150 depending on your condition and age.
This sets the maximum HR you can be paced at. Ideally it should never do anything.

Ventricle Lower Pacing Limit: around 50
This sets the lowest HR you will have.

All the other "features" should be off at this point to see how your heart responds to the basic settings. Then if any condition shows up that warrants additional settings they can be added.

I had similar problems to yours and it was only when I insisted on settings like these that things smoothed out.

frank

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I'm 35 and got my pacemaker a little over a year ago. It definitely is not a burden to me. In fact, I have more energy (which my husband enjoys), can do more things with my kids and have weight because of having the energy.