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Pacemaker implant was July 30, 2012

I posted a question earlier about leads. Now I need help on settings. A have total heart block, depend on my PM 100 percent. This is my 4th but with the others I was always short of breath just carrying in groceries, walking up stairs, etc. My resting bpm was set at 65 and I don't know what the high was set on, I didn't know it was an option. I go to my cardiologist next week and a Medtronic Rep will do the interrogation. How do u know what the high number should be. I am very active, ride horses and hubby and I Team Rope together. Funny thing as physical as that sport is, I am never short of breath. Confusing??
One more thing, normally I am sound asleep about now but instead wide a wake, can't fall asleep, even with meds! Then I am so tired during the day.
Thanks again!

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by Bemarie53 - 2012-08-11 04:08:04

Thanks Don, I appreciate your answer. I take meds for anxiety and depression. This pacemaker thing has been a journey. I guess at some point I will share all of it, I don't want to be chatty! :-). I am glad I found this site, just wish I would have found it a long time ago.
Thanks,
Belinda

Lost my first comment!

by donr - 2012-08-11 09:08:50

Be: I wrote a comment for you yesterday, but somehow it got lost! Gonna try again!


I will address only the SOB issue.

It is NOT confusing to me. I have that situation, also. You are a veteran of 3 PM's plus the current one - sounds like you eat batteries (Burp!), so you know what PM hosting is all about.

I know that my situation is caused by anxiety. How do I know? Because when my mind is thoroughly focused on a project, I never get SOB! Let me be working on something I really don't want to do & I can really feel it in my breathing.

Considering what you have gone through, I can see a true potential for anxiety issues. Not necessarily incapacitating - anxiety does NOT have to be that severe - but perhaps affecting your life in a low level manner. Perhaps so low level that you do not even consider it being a problem.

You need to rule out all things physical & PM setting before falling back on anxiety as being the root cause of your SOB issue. You write like that is what you are trying to do.
There are so many combinations of settings that can effect breathing it is unbelieveable.

Start by looking at a copy of your last download report. If you do not have a copy, GET ONE!!!!! Don't take NO for an answer when you ask for it!

Regardless of whether you have the computer generated 8 1/2 X 11 version or the one printed on a roll of toilet paper, the data you need to see is near the front.

It's called "Parameter Summary." Right there before your wondering eyes it is! Lower Rate; Upper Tracking Rate; Mode Switch (for the RR function). Just following that are the Atrial & Ventricular Long Term Histograms.

Finally, there is a little table giving you the Pacing %.

This data will tell you a lot of what you ask for.

Look first at the histograms - they tell you how high your HR goes. If it NEVER goes high enough - let's say above 100 - 120 - It means that your heart MAY NOT be meeting your body's Oxygen requirements, hence SOB.

With total heart block, your Ventricles do not work on their own, so I suspect that you have no UTL listed. Frank is the expert on Total heart Block so he can answer this one. I only give an educated guess.

As to the sleep issue: That can also be an anxiety issue. It could also be a PM setting issue.

Here's something you can do tonight to potentially sort it out.
Leave a nightlight on & a radio/TV at a very low volume. Just enough light & sound to distract your mind from anxiety caused issues bursting through. Prevents the "Sensory Deprivation" that can occur in total blackness & silence. When you fall into sensory deprivation, your sub-conscious mind bursts through & does nasty things to disturb you & keep you agitated & awake.

Next - ask what your LOWER rate is set at NOW. If you were able to sleep before this PM at a LR of 65, you should be able to sleep at that rate now. If, for example, it has been reset higher, say to 75 or 80, THAT CAN really affect your ability to fall asleep. Why? Because it keeps you at a HR HIGHER than you fall to when totally relaxed. Keeps you alert when you don't want to be.

Hope this has given you some insight into potential reasons for what is happening.

Don

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