nervous

I haven't posted in about a year. I'm the one that had to put a second mortgage on our house to pay for pacemaker surgery in July 2008. because I have no insurance. I don't know if anyone remembers this. Tomorrow I'm going in for a routine PM check. I've canceled the last 3 appts for this because I have very little confidence in the technician, and my PM Doc seems indifferent. We have to pay cash and sometimes, for their mistakes, which is hard to take. My question is this: my "upper setting" on my dual PM is set for 150, and the lower is at 60. I was given the PM because my heart rate had dropped down to between 30 and 40 bpm. I've kinda been in a state of denial all this time, and haven't really educated myself beyond the simple terms. I've been "running out of steam" more than usual lately and wonder if I should ask the Doc to consider settings the upper limit to 160. what do any of you think? Thanks, Janet

6 Comments

Running Out Of Steam

by SMITTY - 2010-03-16 11:03:35

Hello Janet,

First let me say I'm not a doctor and even if I were I would not know enough about your health to give advice, so take my comments with a grain of salt. Also, "running out of steam" can be the result of some heart problem that your PM cannot correct, or it could be anyone of a thousand other things.

Now for my comments. I think you may be going to the wrong end of the pacemaker settings to look for help. Is your heart rate staying at 60 most of the time. Does your heart rate increase with activity? Does it hit, or go above the 150 mark?

Based on what I see in your message you got a PM because your heart rate was dropping too low. The low PM setting is to keep your HR from going below that number and possibly you would benefit from a higher setting say 70 or 80. The upper setting is simply the setting at which your PM will stop sending impulses to replace any impulses that your heart's natural pacemaker fails to send. Above that number the PM just sits there and waits for your HR to come down below that number and then it helps as needed.

So see your doctor and let him tell you why your are "running out of steam."

Good luck,

Smitty

excellent guidance smitty

by jessie - 2010-03-16 11:03:44

way to go smitty jessie

Sensor adjustment might be helpfull

by sherida - 2010-03-17 06:03:07

Dear Janet,
First it is important to know what kind of pacemaker you got and what the pacemaker is doing all the time. Is there a lot of atrial pacing? Than it might be helpfull to adjust the sensor. Not specifically the upperrate, but the way it reacts. They can make it react quicklier on your movements and/or make it increase the pacingrate more or less gradually.
When adjusting the sensor, they might ask you to walk, take the stairs or even run for a total period of several minutes, to see how the pacemaker reacts and determine what is the best way to adjust it's function.
Ratedrops can be prevented by switching on 'flywheel function', 'ratedrop response' of 'advanced hysteresis', depending on the type of pacemaker you got.
All the best!
grtz Sherida

Zephyr....

by sherida - 2010-03-17 07:03:34

I just saw you got a St Jude's Zephyr XL DR. In that case 'advanced hystereris' might be an option or otherwise sensor adjustment. The programmersoftware has an 'easy to deal with' function to do an exercise test and evalulate sensorsettings! If you can provide me with percentages atrial and ventriculair pacing as well as AV-delay settings, I might be able to give you better advice...
grtz
Sherida

HI Janet

by brooke1803 - 2010-03-17 09:03:34

Janet, I am sooo new to all this, just got my PM because I have bradycardia (too low of HR andBP) & My ventricals close off when i am under too much pressure. Seriously just got the Pm 5 days ago, BUT I have to say Smitty is 100% right as to inquiring about setting the pacer # to maybe 70. not raising the higher setting. The pacer number is to stop your HR from dropping hunny..and going into bradycardia... to keep ya from the fainting spells, and light headedness im sure you had. If your still having those probs AND are not comfortable with the cardio you have dear you MUST find a new one!!! You are essentially..and litterally putting YOUR life into someones hands you do not havea good rapore with..you do not trust and so on... Find a new Doc STAT!!! Call and feel around quickly, but let them know you have PM, the doc you have just seriously puts you off because you are a cash paying patient..Hell, If I were a Doc I would rather have a cash paying patient, I KNOW i am getting paid in full instead of the Ins. who has a kick back and the practice has to eat the remainder.

So seriously, please for your health, and emotional well being find a doc you can honestly trust. They hold the keys to your heart hunny. Keep us updated.

Brooke

reply

by janet whidden - 2010-03-17 12:03:42

thanks, smitty for you good counsel. My heart rate is usually between the 80's and 90's. This is very confusing to me, and my lack of insurance and low confidence in my Dr has got me nervous. We're also on a limited income, so I'm trying to self diagnois, which is more or less impossible. I guess I'll just go to the appt and hope for the best.
Thanks again, Janet

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