Setting questions from a newbie!

Hi Everyone! I am 2 and a half weeks post op for pacer insertion. I went for my follow up appt with EP and had my pacer interrogated. As I have read on here I got a printout of the settings and everything. Now I need help deciphering them. I have looked online and at Boston Scientific website but am still confused...I have a DDDR , my lower rate is 75 (which I know is high but before all this my intrinsic rate was in the 80's always and I feel pretty good w/75) and then my "Max tracking rate" is 130. I am 99% atrially paced and 0% ventricular. Does this upper limit mean my heart can't go above that rate? I go back in 10 weeks. I feel pretty good except for a few funky beats now and again. The interrogation showed some PAC's and PVC's but not many however it did show a 13 second period of a-fib?? Which is new as far as I know. I am on a baby aspirin and have been since insertion of PM and EP said that in 10 wks we would discuss this again if necessary. Anyway, any setting info would be greatly appreciated. I have the settings here at my computer so if I left anything out I probably have it readily available.
Thanks in advance!
Catherine

7 Comments

Thank You

by cathtx - 2010-02-13 01:02:31

Thank you Tracey!
That is good info and you helped put me at ease about the a fib...I won't worry about it unless it becomes something to worry about!

Settings

by jvaltos - 2010-02-13 02:02:58

I agree with Tracey's post and would just add that a lower rate of 75 is high and if you start using the ventricular lead for pacing, you may want this to be adjusted downward to save pacemaker battery life and allow you to beat on your own.

IF you are atrial pacing 99% of the time, then you are unlikely to have your heart rate go above 130 as it appears you had this placed for sick sinus syndrome. So, if you are young and want to be active, you may not be able to "go fast" enough and this may need to be changed.

And I agree with the afib comment....don't worry too much about it.

battery

by dwelch - 2010-02-13 06:02:35


I agree with prior posts (traceye and jvaltos) the lower rate seems a little high and may burn through the battery faster. but at the same time if this is what your heart needs this is what your heart needs. Next chance you get ask the doc what the expected battery life is, from your bio you are a year younger than me. So plan for a lifetime of replacements, no big deal but some docs may want to tune the settings to extend the life of the battery. Although I am guessing it may only save one or two pacers over the course of the remaining lifetime. Pacer replacements are no big deal these days, maybe when we are older saving that one last surgery might be good for us. Dont know.

Based on prior answers, your condition sounds to be a different than mine, I have complete heart block and the pacer keeps the ventricles in sync. My expected battery life on the medtronics I have had are 7-10 years, one was 7 the other was I dont remember 8 maybe. your leads are newer technology than mine so that should help battery life.

esp with the newer technology pacers, they are going to tattle tell on you more than you know and tell you about things that you didnt know were going on. this high rate, this event, that event. Just remember that is why you have the pacer, to protect you from the bad events, and not to worry about them. Even though as a collective the pacmakerclub probably knows as much about the answers as your doc, it is probably still good to go through the report you are given on each pacer check. is this lower rate still good, should we change it for any reason, I feel tired all the time or I cant sleep since I have had a pacer, maybe it is too low or too high. What does this voltage mean what does that number mean. A good doc will go through it line by line, a not so good doc will tell you not to worry about it and send you home, which to me is a sign to look for another doc. Either way keep asking these questions, 22 years with a pacer and I am learning so much now that I started hanging out at pacemakerclub.com


battery life

by Tracey_E - 2010-02-13 08:02:55

How much you pace is only one factor in how long a battery will last. I pace 100%. My first pm was estimated 4-5 years but I got 7 out of it. I'm very consistent in how I use it so they were able to turn off a lot of the extra functions I don't use and turn down the safety margins. These things have a much bigger impact on battery life than how much you pace. Point is, don't lose sleep over how much you pace. All that matters is if you feel good.

settings

by Tracey_E - 2010-02-13 11:02:27

DDDR means rate response is turned on so your pm will be sensitive to movement and raise your rate for you when you are active.

Max tracking rate means it will only pace you as high as 130. If your heart goes faster than that on its own, the pm will just watch. This setting is more important to those of us who pace ventricular- our atrial rate is more or less normal but we depend on the pm to keep the ventricles in sync but the pm will only pace us as high as the max rate.

You may have had small episodes of afib before and just didn't feel it. Pm's tend to catch things we didn't know about before. It's also possible it's just your heart getting used to having two wires in it and it's a little agitated. One run of 13 seconds is nothing to worry about!

The DDDR can be misleading

by ElectricFrank - 2010-02-14 01:02:11

Some of the pacemakers have the letters DDDR in their model name, which only indicates they are capable of DDDR mode. On the printout be sure you are looking at the MODE being DDDR to find out if rate response is ON.

In your case I suspect it is, but just wanted to make others aware of it. I just noticed it recently. The technical manual for my Adapta pacemaker calls it a Dual Chamber Rate Responsive Pacemaker (DDDR). However, mine is set to DDD mode.

frank

Welcome

by SMITTY - 2010-02-14 05:02:48


Gello Cathtx,

Welcome to the Pacemaker Club.

High and low pacemaker settings are the result of what the doctor thinks a particular person needs. I've seen some of our members say their low setting is 30 and one say their low was 90, so I don't think there is a "one number fits all."

In my case my low setting is 80 and the high is 120. But then I'm old and my heart has lots of damage which started with my first heart attack in 1982, so these numbers work best for me. I can say that before my 80 setting I had a 70 low setting and that gave me a pacemaker that was for all practical purposes useless. Kicking low setting up just 10 points makes all the difference in reducing PAC, PVC and skip beats, the way I feel and my allowable activities.

Every PM patient should know what their settings are, and if they think a different setting would serve them better they should talk to their doctor. Since you are a newbie and you will find having a pacemaker is a learning experience. So, if I could make a suggestion don't be influenced by what you read or hear about the settings other people have. On the other hand never be absolutely certain that what the doctors chooses for you is the last word in settings. To get the optimum results from your pacemaker you must have an on going dialogue with your doctor about how you feel and what you think the pacemaker is, or is not doing for you. The dialogue is necessary because unless we tell the doctor we think this or that is happening, the Dr has no reason to think things are not perfect. Information obtained during checkups can show some things, but the best source of information is the patient.

Good luck

Smitty

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