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Maybe Don can explains this
- by wandoloswki
- 2013-06-19 09:06:50
- Checkups & Settings
- 1403 views
- 9 comments
Maybe Don can explains these settings.
MODE:DDD 60 BPM
MAX TRACK 120 BPM
MAX SENSE 130 BPM
MODE SWITCH 170 BPM
PACING THRESHOLDS:
ATRIAL:0.5V @ 0.4ms
VENTRICULAR:0.2V @ 0.4ms
SENSING THRESHOLDS:
ATRIAL:4.4mV
VENTRICULAR:>12.0mV
LEAD IMPEDANCE:
ATRIAL:590 Ohms VENTRICULAR:700 Ohms
AS-VS=49%
AS-VP=0%
AP-VS=50%
AP-VP=0%
9 Comments
PM102
by Grateful Heart - 2013-06-20 01:06:21
Nice job Don, as usual. Like Lou, waiting for PM102.
Grateful Heart
Understood
by Sandra! - 2013-06-20 03:06:15
Very comical explanation, you passed your final exam!
Thank you Don for sharing your wisdom with us!
Sandra
Don to the rescue...
by lubro - 2013-06-20 12:06:37
as always... Wanda...hope you learned as much as I did from this... that's the beauty of being a member here...so many knowledgable people here willing to take the time to help others ... thanks for the Great explanation Don...
btw Don... where do we sign up for PM102 ?
on behalf of all who enjoy your posts and your humerous way of helping us all... just want to say a
BIG THANKS...
Lubro
Note to Professor Don
by Moner - 2013-06-21 12:06:52
Where do we register for PM 102, I'll be in line right behind Lubro.
Will Tracey fill in on days when you'll be trapped in your home, because that mean old bear will not let you out of your house?!
Casper
101% in agreement
by Sandra! - 2013-06-21 12:06:59
I agree with Lubro and Grateful Heart, this is a great community where we all learn from each others knowledge and life experience.
Looking forward for next term to read about PM 102!
Sandra
p.m. 102
by wandoloswki - 2013-06-23 02:06:58
Can I get the p.m. 102 on this thread for the inhibit feature of the P.M. Don?
Casssperrr !!
by Grateful Heart - 2013-06-24 12:06:08
No cutting ahead of the line....:)
Grateful Heart
You know you're wired when...
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I feel so blessed to have this little gem implanted in me. When I think of the alternative it is quite overwhelming sometimes.
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by donr - 2013-06-19 11:06:13
...from watching a Granddaughter graduate from HS & what do I run into but a final exam - that isn't even multiple guess! Oh, well...here goes:
MODE:DDD 60 BPM - First position: D=DUAL - chambers that PACE. Can be D=DUAL; A=Atrial; V=Ventricular; O=None.
Second Position: D=DUAL - Chambers that sense for voltages in heart. All letters mean the same thing as for First Position.
Third Position: D=DUAL - Chambers that are INHIBITED from having pacing pulses sent to them IF the PM senses that there is a voltage present in heart. All letters mean the same thing as for other two positions.
There is usually a 4th position that is filled - That is an R - for Rate Response function is turned ON.
In your case, you have BOTH chambers paced; BOTH chambers are sensed & BOTH chambers have the inhibition function turned on. There is NO R, so your Rate Response is not activated.
There are several other options, but for basic knowledge, these will tell you what you need to know about what your PM is set up to do.
The PM uses the same leads to send its pacing pulses & "Listen" for voltages in the heart. It will send a pacing pulse then switch over & "Listen." If it senses a voltage, it will disable (Inhibit) itself so it does NOT send a pulse while the heart already has electrical activity going on. The reason for this will be covered next term in PM102 - this is only PM 101.
The 60 BPM is the base rate that your PM will allow your heart to drop to. It will "Kick in" if it senses that on ANY beat the heart will drop to a rate that equates to less than 60 BPM.
MAX TRACK 120 BPM - Ah, now we get to the upper limits that the PM functions at. Note that this limit is 120 BPM - less than the next on on your list. Your PM will track your heart functioning up to this point & try its best to make the Ventricles follow the atria to this point. IF your atria goes above 120 BPM, the PM says "Whew!" wipes its brow & says I quit & just turns into a passive monitor of events - up to...
...MAX SENSE 130 BPM. At this point it realizes that there is no way that your ventricles can do the heavy lifting of moving all that blood through your body & the PM starts doing what is called a 2:1 block, where it sends a pacing pulse every 2nd beat of the atria & you feel like crap because your heart is not truly coordinated, but it keeps you alive & conscious.
MODE SWITCH 170 BPM . At 170 BPM, your PM looks at the situation & realizes that it is time for drastic action & automatically switches you operation mode from DDD to some other mode that your Cardio has selected & does not show here.
PACING THRESHOLDS:
ATRIAL:0.5V @ 0.4ms - It takes a voltage of .5 Volts that lasts for .4 milliseconds to make your Atria contract. That's a pretty small voltage & a VERY narrow pulse width. IT is so narrow that it barely shows up as a short vertical line on an ECG. Unless you know what you are looking for, it's difficult to see.
VENTRICULAR:0.2V @ 0.4ms - Same as for the Atrial described above. EXCEPT this voltage is only .2 volts & lasts for .4 milliseconds. (A Millisecond is 1/1000 of a second)
SENSING THRESHOLDS:
ATRIAL:>4.4mV - The heart has to have a voltage that is GREATER than ONLY 4.4 millivolts in the atrial area for the PM to sense it. A millivolt is 1/1000 of a volt - not much! The symbol ">" is shorthand for "Greater than."
VENTRICULAR:>12.0mV - Same as the definition for the Atria, except this is for the ventricles.
LEAD IMPEDANCE:
ATRIAL:590 Ohms - IMPEDANCE (Sometimes called RESISTANCE) is a measure of the resistance of the leads to the flow of the electrical current that the PM puts out in its pacing pulses. The greater the IMPEDANCE, the harder it is for the PM to force a pulse through the lead. Your PM measures the electrical resistance of its leads every night while you lie sleeping & sawing logs. It is also an indicator as to the electrical health of the leads & their implant site quality. If a lead gets a crack in it or the implant site goes bad, the measured resistance goes up & the PM stores that data & spews it out next download for the PM Geeks who read all that stuff to go oooooooH; aaaaaaaH! over & start becoming concerned that you have lead problems.
VENTRICULAR:700 Ohms - Note that the resistance of the Ventricular lead is not the same as the Atrial lead. Measured the same way, however & has the exact same meanings.
AS-VS=49%
AS-VP=0%
AP-VS=50%
AP-VP=0%
Tracey covered these last post you made - they haven't changed since then!
Hope this makes some sense to you. There's a lot more to PM parameters than this, & I have simplified the definitions into non electrical engineer terms (I think) so you will have a reasonable idea what the PM is doing & how it does it.
Don