Pacer Check

Well, I finally got in for my 3 month post pacemaker implant check up, which turned into a 4 month checkup due to a cancellation in December. Doc says everything looks great, pacemaker is pacing but my heart is pacing on its own more (which means if it keeps this up my battery is going to last a long time!)

I posted a while back about my heart rate going up while driving or riding in a car and I said I would let you guys know what the doc said about it. He said there is a sensor in the pacemaker ( he did not say anything about rate response although I guess it could be the same thing) and that the sensor is sensing movement and thinking it's me exercising which is causing an increase in heart rate. I drive a mid-size SUV that is not a very smooth ride and the bumpier the road is the worse the pacemaker responds. It's not dangerous and he suggested taking deep breaths (which I already do and it helps) to get some extra oxygen in my lungs and it should calm things down. That setting can be changed but he didn't want to change it and I'm ok with that because I can deal with this and don't want to change anything that is not necessary because I sure don't want to risk messing anything up!

So, all is well in my pacemaker world. I'm actually learning to live with this thing! Now if I can just get my sleep issues under control it will be great!

Hope all of you are doing well also.
Kathy

4 Comments

You have it right about Rate Response

by ElectricFrank - 2013-01-29 01:01:05

The doc doesn't when he says deep breathing will slow your HR under these conditions. The Rate Response device is a strictly mechanical accelerometer which knows nothing of your oxygen level in your lungs. It has settings which help it identify the source of movement and respond appropriately.

There is no reason not to try some small changes in the RR to improve the situation. Unlike many therapies the pacemaker settings are totally reversible if new one don't work out. My guess is that it is for the doc's convenience that he doesn't want to make changes. Or he may not be competent in handling the RR.

By the way it is possible you don't need to have the RR activated at all. It is common for it to be left on as a factory default and we have a number of folks here have major improvements in comfort when it is turned off.

It's unfortunate, but one of the things we need to constantly be aware of is the incompetency and laziness of many doctors these days. With the increased technical complexity of devices they can't keep up with it. Some like my cardiologist uses the Medtronic rep to handle the pacer adjustments, and he remains an excellent surgeon for implants. Others, are so ethical.

frank

frank

Too Busy

by kwhite62 - 2013-01-29 09:01:38

The only reason I can think of that my doc wouldn't want to make the adjustment to the RR is that he's just too dang busy! Which is no excuse of course. It's not uncommon to have to wait 3 hours at a scheduled appointment. He is a good doctor and knows his stuff. He does all his own interrogations and pacer adjustments which leads me to think he may have some "power" or "control" issues. :-)

If you remember in some previous posts, back shortly after I had the pacemaker surgery, I had a span of about 6 weeks of very little sleep and loads of stress due to the excessive amount of PVCs and PACs I was having post implant. It took me having a meltdown on the phone with his nurse and threatening to go elsewhere before he would actually "hear" what I was telling him. They worked me in the next day and he made some pretty simple adjustments and it made ALL the difference in the world. Yesterday, I did not insist that he do something about the RR because I am terrified of going through all of that again. I'm afraid if he turns it off or adjusts it somehow it will throw something off and start up the PVCs again. I know we could undo it if it caused a problem but I just don't want to go through it again. But, if you guys think it wouldn't cause any problems but would make "the car ride" better, I'll consider having him adjust it or turn it off and see what happens.

Thanks so much for your comments. It's always so helpful and makes me feel better just knowing others have had some of the same experiences and have gotten solutions. Thank you!

Time to get serious

by ElectricFrank - 2013-01-30 01:01:28

You are not getting the service the doctor is charging for. That's the primary problem. It doesn't matter how busy he is. That is his problem. Look at it this way. He may be an excellent doctor, but all the excellence in the world is useless if he doesn't apply it to you in a timely manner.

As for the PVC's early on one of the common causes is the high pacing voltage irritating the heart wall. He should have seen you for an initial adjustment in a timely manner and you wouldn't have gone through the stress. So turning off the RR is very unlikely to cause PVC's. The most likely problem would be shortness of breath from too low HR if you actually have Sick Sinus Syndrome. Your original ECG before getting the pacer would have shown that, but my guess is that this guy never looked at it beyond the computer analysis which is not trustworthy. So what you need is to have the RR turned off with the provision that you can come back in a few days to a week if it doesn't work out.


But, I would have dumped this guy in a week. One phone meltdown is one too many. I see you have a Medronic pacer. Call around and try to find a doc who uses a Medtronics rep for the adjustments. They are excellent.

best wishes,
frank

Thanks Frank

by kwhite62 - 2013-01-31 10:01:22

I've given it a lot of thought the past couple of days and I'm considering changing doctors. I have a friend who has been in the pacemaker/ICD business for years and she has suggested a doc for me to see. She works mainly with St. Jude devices but this group of cardiologists work with the Medtronics reps, too.

I don't understand why this is such a difficult decision for me. I just need to do it and I'm sure I'll feel better for it.

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My ICD/pacer is not a burden. I still play tennis and golf.