Puzzled

In 2009 I was diagnosed with Total (Third Degree) Heart Block. As a result I was fitted with dual lead pm and have attended pacing checks since.
At a recent check I was told that my atrial pacing was about 52% and ventricular was about 54%. I understand that "block" is a break in the electrical connection between the top and bottom half of the heart but that the atrial sinus is unaffected and continues to work normally.It is only when the impulse fails to reach the lower chambers that the pm kicks in and gives these chambers a shock.
Why, therefore,am I being told that my A lead is pacing?
GEW

2 Comments

Atrial pacing

by Loganwh - 2011-11-18 09:11:19

Hey Graham. One thing you have to keep in mind is the atrial pacing % accounts for all hours of the day. ( Sleeping, awake, etc.) Our heart decreases while we rest, therefore if your natural sinus heart rate decreases below your lower tracking rate (base rate) your atrial lead will pace. It's not a. Terrible thing to be atrial pacing. Hope this helps.

Reasons for atrial pacing

by ElectricFrank - 2011-11-19 12:11:58

The most like reason is having the lower limit set too high. If so then the normal drop in HR during relaxation or sleep will cause the atrial pacing to kick in.

In my case the original lower limit setting was 70bpm. My resting HR is around 56-60 so anytime I relaxed or slept the pacer took over and held it at 70. This meant I was atrial paced 100% during sleep. At my insistence they lowered it to 55bpm. My atrial pacing now runs around 2-5% which happens when the pacer adds a atrial pace after 2 PVC's in a row. All it would take to raise my atrial pacing dramatically is to increase my lower limit to 60 and I would go back to pacing all night.

When I ask for the change the cardiologist warned me that I would be feeling low energy with the lower setting.

The other thing to check on is the pacing Mode. For your condition it should be set to DDD. If it is set to DDDR it means that Rate Response is activated which can also cause unwanted atrial pacing.

Hope all this makes sense. If not let me know,

frank

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