PM usage time...

As a result of a complete heart block, ended up with a PM on 17November2009. Was told by a Medtronics technician that it is being used 5% of the time.

If the PM is being used 5% of the time, is this criteria based on the heart rate going to 60 or below in a certain timeframe? If so, what is the timeframe?

If not, can someone shed some light as to how this 5% is calculated/determined?

Thanks for your help.

12 Comments

pm usage

by tcrabtree85 - 2009-12-04 10:12:33

Somebody much better at explaining hopefully will give you the answer you are looking for. I will give it a stab though.

The pm is always on stand by when you drop below the setting rate that is set so if your rate is set at 60 and you drop below that rate it sends a signal to help put it back in a normal rate. So a dependent person who can't maintain a high enough rate to stay functioning would be paced more often.

5% of the time is not bad at all. It may change over time how dependent your heart becomes on a pm but overall that 5% is telling you that your heart drops below the pm setting.

Hope that helped you some.

Tammy

PM Works 5%

by SMITTY - 2009-12-04 11:12:26

Hello Marie,

Your pacemaker being used 5% of the time says it is help you heart out about 72 minutes of each day. Most likely that is occurring when your heart rate drops below the low set point of 60 on the pacemaker. However, it can also be at any time your heart rate is above the 60 BPM if the pacemaker detects your heart not sending an impulse to make the heart beat.

Actually the pacemaker will monitor and send an impulse to make the heart beat anytime it senses the need when you heart rate drops below the low set point all the way up the upper set point. Times it very difficult tol state with certainty exactly when the pacemaker is helping out. Put anothe way, the pacemaker sits there monitoring your heart function ready to lend assistance anytime it senses the need.

I know I've been redundant in this reply but your question is one that is more difficult for me to answer than it first appears so I hope I haven't confused you too much.

Smitty

% PM Useage

by SMITTY - 2009-12-05 03:12:45

The more we (or maybe I should I) talk about this the more confusing it seems to get. You are correct the 72 I mentioned is the amount of minutes (24 hrs. X 60 min. X .05) I calculated as an average amount of time your PM would pace your heart each day. Now here is the ringer in that. I doubt seriously that your PM works on an average of anything. So saying 5% of the time would be 72 minutes/day may be totally erroneous. Your total 5% may for a given period of time that may happen in a one, two, three, or more intervals of time. I used the 72 minutes to indicate about how much time of each day the 5% represents.

Possibly the people that do your checkups can tell you when this 5% pacemaker help is occurring, but I'll be surprised if our PM records that much detail. At my last check up they told me that my PM was pacing the upper chamber about 93% of the time and the lower chamber about 3% of the time. The only thing that surprised me about those numbers was that the upper chamber was being paced less that 100% of the time. My natural heart rate is in the 45 to 55 range and with my low PM setting being 80, I just figured the PM was pacing me all time. In reality, to me, it is just numbers and until they try to tell me the PM is pacing me more than 100% of the time I'll accept their word without question.

I have two reasons for accepting with out question. First, so long as the PM works I don't care how much or how little as there is nothing I can do to change it. Second I have learned that if I ask the people doing my checks I'll get an answer, but I now know it may not be very accurate. I don't mean I think they lie to me intentionally, but it is just that they feel obligated to give an answer so I get their best guess if they don't know because they figure I don't know either.

It is possible

by wenditt - 2009-12-05 06:12:28

I have complete 3rd degree heart block, aka complete heart block, but not all the time ... just like you. I pace about 3% of the time. It is possible to have "episodes" of complete heart block where "for whatever reason" your electrical system doesn't work. When that happens as I am sure you already know that dizziness, fainting, syncope usually occur. But if your heart is strong it can "reset" itself rather quickly avoiding death. I was told that when you are younger your heart can respond and reset faster than when you are older, therefor people who have this condition when they get older, cannot overcome with episode as quickly as we can. Those people usually pace at percentages much much higher than us....for now.

You may notice that you begin to pace a little more and more each time. I have been told that eventually I will pace 100% of the time...that my electrical system will just burn out one day. Why? Bad luck is all and age. That my heart will age with my body but because it's already a little "disadvantaged" it may happen in my 60's...but no one knows for sure.

I started out pacing at 1% and have been slowly creeping to 3%. Not happy about it but what am I going to do! LOL

Best of luck-
Wenditt

Complete Heart Block

by SMITTY - 2009-12-05 10:12:18

I have a question and this is not some veiled attempt to dispute someone's word on this subject.

When a person has complete heart block I can understand that means the heart's natural pacemaker is not generating the necessary electrical impulse to make the heart beat as it should. I say beat as it should because I understand our heart has a backup system that can come into play in case of an emergency such as this. While that backup system may keep us alive for a while we are going to have what I think is called cardiac insufficiency and we must have help from something like a pacemaker soon.

So if we have complete heart block (from natural causes as opposed to an ablation) is that heart block always permanent? Or can it be one of those ailments that come and go. If is not permanent I can see how a patient can be diagnosed with complete heart block and be in urgent need of a pacemaker, only to find out later that pacemaker is not having to work full time.

Just some thoughts on a Saturday morning when it is too cold to go outside and play.

For what it's worth-

by ecf2xtreme - 2009-12-05 11:12:26

I was told that I have intermittent complete heart block. At my last check I was pacing 43%, up from 22% at installation in 1/09. Oh, and pacing pretty consistently both top and bottom.

Speaking of cold, we got snow last night!

Strange

by ElectricFrank - 2009-12-05 12:12:04

My reading of the definition of Complete Heart Block is that there is a total loss of conduction from atrium t ventricles. The criteria for pacing is that there is no ventricular contraction based up the atrial contraction. With a complete block this requires near 100% pacing. The report of 5% pacing doesn't match complete block.

frank

PM usage

by LoobyLou - 2009-12-05 12:12:25

This is something that puzzles me too. I had my pacemaker for “2nd degree Mobitz type 2 heart block /complete heart block” which I understood to mean that sometimes I was in complete heart block when the signals were not getting through at all but at other times some signals were getting though to the ventricle. At my first check up 6 weeks ago I was pacing “more than 99% in the ventricle and 5.2% in the atrium." So maybe for some of us the "complete heart block" is intermittent. Does this help or am I talking gibberish?
Julie

%/blockage/pacing?

by Carolyn65 - 2009-12-05 12:12:46

I have to claim I am still a "newbie" to all this foreign language. I had PM on 10/2/09 & don't have a real PM ck. until 1/10/10 so I still have no clue what all this means, nor do I know what to ask the techie in Jan. All I knew to ask when they ck'd. in the hospital was what "it" was set on ~ "80" like before PM for the 1st 3 months I have it. I read all the comments/questions & still don't catch the lingo ~ will in Jan. I am sure!

Yes, for TEXAS, the weather yesterday (Friday) was very unusual. In the middle 30's all day, snowed heavily for Texas @ 3:00 p.m. here, did not "stick" and in the 20's last nite! Hey, we live in Texas to be away from the cold. The norm for my area is 40's - 60's this time of the year. I live in a rural area with exposed water pipes (hey, we are not supposed to freeze). Wrapped and dripped inside/outside pipes all nite, plus kept a lil' heat going in the house with kitchen/bath cabinets open for warmth on the pipes (I use propane heaters).

Hey, you, my friends in Austrailia, this is your hot summer! My daughter attends a wedding there in April.

Take care and our prayers and thoughts are with you.
Carolyn G. in Central TEXAS (GO UT LONGHORNS Tonite @ Arlington, Texas)

PM Usage...

by Marie - 2009-12-05 12:12:55

Thank you very much for all the replies. Some very good information and food for thought!!

As far as a complete heart block, that info given by my Cardiologist, and to be more specific, it was defined as a third degree atrio-ventricular heart block. It does not happen all the time, but when I do certain things, like going up steps, walking for a while (like at a big store like Walmart’s), working in the yard, etc. (Won’t have to worry about the yard until next April!). Also, it may only be 5%, but the feelings associated with each occurrence are rather unpleasant, even if it were to happen only once a day.

If I understand the explanations provided here correctly, the heart should beat at a rate of 60 beats per minute, or higher. The 5% indicates that the heart is not doing so in 72 occurrences, or that the pacemaker detects that the heart is just not sending an impulse to make itself beat regardless of the beat rate.

Now, what mathematical calculation is used to arrive at the 72 occurrences? It cannot be a minute, because 72 exceeds 60 beats. The 72 is 5% of 1440. Is 1440/60 = 24 hour period?
So, are the 72 occurrences happening in a 24 hour period? Please correct me if I am wrong.

Once again, thank you for the helpful information. I am glad this avenue is available to discuss these matters.

3rd degree complete heart block

by Hot Heart - 2009-12-07 06:12:04

About 90% of the time. lol.

HH

PM usage

by Marie - 2010-02-12 11:02:21

Hello folks!!

Have found out a little bit more info, and the 5% pacing means that out of every 100 beats the heart takes, 5 of them are intercepted by the pacer. My heart has been beating at about 100 times a minute, so, if in one hour it beats 6000 times, I presume it is then being intercepted by the pacer 300 times every hour.

Now, the pacing can be broken down into what is happening in the atrium, and what is happening in the ventricle, each with its specific (%) values. My next point of confusion is, when told that one is pacing at 5%, and it is not broken down into atrium or ventricle, what does that 5% represent??

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At age 20, I will be getting a pacemaker in few weeks along with an SA node ablation. This opportunity may change a five year prognosis into a normal life span! I look forward to being a little old lady with a wicked cane!