Can you feel it when you're being paced?

Hi
I'm only paced in the ventricles when I'm exercising, but I can feel it a lot and its really annoying b/c its so irregular (it can only go up to 150 though my atria are going up to 190). Just wondering if its normal to feel the pacing in the ventricles? I just went for my checkup today and they're talking about putting a new one in that can go higher because I'm an athlete and they didn't take that into account the first time around. I don't really want to get a new one since I've only had this one in for 2 months now, especially if I'm going to feel the pacing regardless...anyways just wondering if that's normal or not. Do you feel it less when the amplitude is turned down after 3 months?
Thanks for the help,
Melanie

12 Comments

not usually

by Tracey_E - 2010-10-27 09:10:03

It's possible but quite rare to feel the pacing. It's more likely you're feeling something odd because your atria is getting so much higher than your ventricle- you're feeling it be out of sync rather than the pacing.

I would hold off changing to one that goes higher until this battery goes! Have they discussed a beta blocker as a short term option? I had a similar problem, my atrial rate got higher than the pm could pace during exercise also. I'm not what you'd call an athlete by any stretch of the imagination, but I'm active and work out regularly. My dr said that while it's perfectly safe for me to get up to 180-190 while working out, I don't really need to be that high. I'm on a low dose beta blocker and my rate doesn't go much above 150 now. My pm is set at 170 and I haven't had a problem since, and I didn't go with the Medtronic with the higher limit when I had my last replacement. There are downsides to being on a beta blocker but it might be worth a shot. Personally, I'd rather give that a try than have another surgery or deal with maxing out the pm every time I work out. Just my opinion, take it with a grain of salt. :o)

The pm won't go over 150 or they don't want to set it over 150? I could easily be wrong but I thought most of them went to 180, the exception being the one Medtronic that goes to 220.

won't go over 150

by wmelanie - 2010-10-27 11:10:10

Its the new MRI compatible medtronic and they've tried every creative setting possible, but it can't track or pace over 150 which is a problem because I'm 22 and an athlete so during workouts and playing sports it tends to be from about 140-190. So the majority time that I need it it won't go high enough. They've never mentioned a beta blocker, though it might be worth asking about if it will help. Not too sure about it being a short term option though because it will be like ten years until the battery runs out... Could you feel it was out of sync when your atrial rate went above what your pm could pace?
Sorry for all the questions, just really frustrated that they couldn't just put the right one in the first time...

model number

by wmelanie - 2010-10-28 06:10:35

My model number is EMDR01, its the Medtronic Enrhythm MRI surescan. Thanks

out of sync

by Tracey_E - 2010-10-28 07:10:53

You can definitely tell when you're atrial rate is higher than your ventricle is pacing! I get dizzy, short of breath, heart feels thumpy.

You could take a beta blocker long term, by short term option I meant until your next replacement. I've been on it a year now and haven't maxed out once. Before, I was maxing out every time I tried to work out. It took a few tries to get one I could tolerate due to the side effects.

I'm with Frank, I've never heard of one that won't go higher than 150, but I'm not familiar with the new mri-compatible ones either so who knows (but Frank will find out, he's awesome like that!).

Who's making your adjustments? A cardiologist, ep or Medtronics rep?

Beta Blocker Change

by donb - 2010-10-28 09:10:47

With my 4th PM Feb 2009 St. Jude along with a change of Tenormin to Betapace I have experienced a great improvement in stamina. My previous PM was Medtronic Enthrym set at 60-130 while taking Tenormin. As participating in Cardiac Rehab I found I would get near my top 130 very quickly doing treadmill at my age of 77.

Since my new PM St. Jude with medication change (Sotolol) and my PM set 60-120 I have greatly improved my physical stamina as I can comfortably do a 50% improvement on treadmill performance. I find my HR between 110-115 while doing strenuous yard work doing more than at age 60 pre-PM days. I am carefull not to exceed my top PM setting as then I feel about like my car feel when I hit the engine limit control.

My point in this posting is why is there such a time gap in getting proper PM settings? Just how many, especially young people are limited physically from having quality of life because of running on "Factory Settings"? If it were not for members like Electric Frank & others I would still be feeling like an "old person". 79 coming up Jan 13th!!! donb

Bad information

by ElectricFrank - 2010-10-28 12:10:45

I don't know of any Medtronic pacemaker that is limited to only tracking to 150bpm.

You may need to push them on the info. If necessary post the model number of the pacemaker from the ID card they gave you at implant. I will attempt to access the technical manual for it to see if they are being honest with you (or possibly just incompetent).

best,

frank

I agree with Donb!

by Heidiglassmeyer - 2010-10-28 12:10:48

I am an active 42 yr old and I thought it was crazy that I had to so in so many times for an adjustment in my first 6 months. I understand you heart does have to get used to pacing but really! I was laughing with my sister-in-law who is a PA that maybe I needed to find a pediatric EP/Rep that may be better at making adjustments for younger PM users lol! With so many younger people receiving PM's I think it is time for some retraining on PM settings! :). OK, off my soap box.....

Heidi

Melanie

by ElectricFrank - 2010-10-29 12:10:01

Just spent some time with the manual for the Medtronic Enrhythm P1501DR system. Yours may be too new for them to have the manual posted yet, or the EMDR01 is just one in the series.

Anyway, this series uses a different method of setting upper atrial tracking limit than previous pacers. As I read it there is no direct setting for the upper Atrial Tracked-Ventricle Paced function. The actual upper rate is determined by several time interval settings instead.

However, to make things more confusing there is an Upper Tracking Rate setting which is actually a Rate Response setting,and I doubt you are using it.

Have the local people contacted Medtronic for help? That would be the best approach as they would know for sure.

As for replacing it my guess is the feelings you are getting is due to the irregular beats with the 150 limit. They are not only uncomfortable, but not good for your body long term. Keep in mind that right at the point where you are exercising at a level requiring good blood flow, your heart is missing on several cylinders.

Hope this helps. Feel free to get back to me if I wasn't clear enough.

frank

One more comment

by ElectricFrank - 2010-10-29 12:10:56

Using meds like beta blockers to compensate for the pacers limitation is a bad idea. Kind of like eating saw dust to lose weight. Pacers are simple devices that work well long term and don't have nasty side effects.

frank

Yes, I feel it...

by Tracie H - 2010-10-30 07:10:48

I feel it when my PM paces. After several complaints to the doc, a newer nurse (although experienced) told me sometimes people can feel it. She explained MY situation like this:
My heart is a little too centered than most...usually it's off the left of center. My heart is also smaller than most - sort of like a teenagers. Because of this, my vagal nerve runs closer than usual along the side and one of my leads is run nearer the vagal nerve. She suggested when I pace, the lead irritates my nerve which leads me to feel being paced. All I get is tickling sensation...sort of like when I do a phone check. It just makes me cough a little and reminds me that I get to be alive.

Perhaps yours a similar situation?

Tracie

Which Medtronic will go to 220bpm?

by camgough - 2011-01-12 09:01:11

"the exception being the one Medtronic that goes to 220."

I have a Medtronic Adapta ADDRL1 that was put in July 2010 in Ottawa, Canada. The doctors told me it was the best they had. I have a dual chamber, set in DDD mode for heart block. It senses my atriums, paces my ventricles.
On insert day it was set low 60, high 140. Then I had it changed to 60 / 160, and more recently 60 / 180. I am finding now that my low can get down to 60, and with jogging my high gets to 180 quite easliy. Since I am 30, my approximate maximum HR would be 190. Pre open heart surgery I don't recall my HR ever getting past 190. I am curious what the maximum high pacing rate is with my pacemaker. I don't have access to the manuals. Is there really a Medtronic that goes up tp 220??

Any new info here

by vdwyer1 - 2011-02-27 11:02:23

I'm about ten weeks post op with an enrhythm1501dr and I've just run into the 150 limit. It was set at 140 and they agreed to move it to 170, but apparently can't without some new software upgrade which is supposedly on the way. They moved it to 150 for now. As a runner that can work up into this range pretty easily, i'm wondering if this is the right pacer for me. If not, I'm more than just a little annoyed that this discussion wasn't had prior to implantation. My cardiologist knew I was a runner, although not sure this was presented to the EP cardiologist. Anyone know if this pacer has advantages over others with a higher limit, that might have made it's use necessary or preferable?

Thanks,

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