Pacemaker setting

I have has a BIOTRONIK Evia pacemaker for 17 months. I had it adjusted last month so the sensor went from low to medium. This is not technical but when my blood pressure drops when I stand ( due to orthostatic hypotension) my heartrate jumps. My pacer reads the blood pressure changes and the medium setting means it is more sensitive to blood pressure drops and will jump my heartrate more quickly, This pacer is good for people with dysautonomia.

Well I hate the setting change. It has caused me to be much more symptomatic. So for the last week I have been trying to get my out-of-state cardiologist's office and my primary doc. to coordinate having my pacer setting changed locally. ( which was agreed upon before I had surgery). We all know this takes 5-10 minutes but after 9 calls and 3 emails I can't get this to work. So I got a new cardiologist today who will see me in a few days.

Here is my concern. Originally the woman on the phone said they only had Medtronik devices then came back and said they had a tech. who could change my BIOTRONIK. Anyone know are there different machines for each pacer? I need one tiny little setting changed but need it done correctly. Thanks.

3 Comments

Techs are trained

by Theknotguy - 2015-03-18 11:03:54

Some techs here are trained on more than one PM. I'm not sure if they carry the PM readers around with them or if they're specific to the EP's office. My EP does Medtronic, Boston Scientific, and St. Jude. Does about 33% each so if there is a problem with a manufacturer, only a limited number of patients are affected. Consequently there are three readers in the office.

The last tech I had was trained on all three PM's. He was putting the one reader away as I went into the room. Then switched over to Medtronic and read mine.

If the doctor can handle three different PM's I don't see it as a problem for the tech. Basically those things are fat laptops with captive software. Mostly they're just tapping request points on the screen and requesting a printout. So I don't see it as a big deal unless the tech starts thinking he's better than the doctor and starts switching stuff without authorization.

You'll occasionally read about it on the forum where the tech switches something and the patient doesn't know if the tech decided to do it or if the doctor authorized it. Personally (having been a computer geek myself) I understand how tempting it is to just go ahead and change something. But a tech doesn't have the doctor's training. So I'm not in favor of it even though I know how a tech thinks.

When I wanted a specific program turned on with my PM, the EP made the change. I was a lot more comfortable with that.

You can ask the tech if he/she has been trained in multiple PM's. Once you learn one it shouldn't be that hard to pick up another but still, I'd ask. You don't want anyone saying, "Oops!"

Hope things go well for you.

Programmer devices

by golden_snitch - 2015-03-19 02:03:30

Yes, each manufacturer has a different programmer device. Not a different one for each pacemaker, ICD, CRT model, though, just one its whole portfolio of products. The clinics/cardio offices I have been seen at had the different devices from all manufacturers there, even if they implanted only pacemakers etc. from two or three manufacturers. Biotronik's CLS sensor is a bit special, and there are not that many doctors or techs out there who know it very well. So, it would definitely be good to have someone come in who knows your Biotronik pacemaker.

Good luck!

What's comimg to a Cardio....

by donr - 2015-03-19 08:03:01

.....practice near you - & you may not like it!

Before my cardio sold his practice to a major teaching hospital (Emory) here in Atlanta, GA. USA, he had a circuit -riding Medtronic Rep that came by periodically on set days of the month. I have no idea if he paid for the visits, or they were paid for out of the initial purchase price for the PM/ICD. etc. But these guys (male & female types) knew the guts & programming like the palm of their hand. They would visit the host first, do their downloading & checks, give us a chance to ask questions & then the "Great Man," himself joined the party in the former mop closet that served as his examining room. He went through the Company Tech's download, they discussed it & then he got to me. No tech EVER dared to make a change to any parameter w/o the approval of the "Great Man." It was not even suggested till he asked their opinion/observations after he went through it.

I recall vividly a relatively new Tech who had been interrupted in our private session, hesitantly asking the "Great Man" a question about something he saw that he thought was seriously wrong in the report. The "Great Man" politely responded that "...for this guy, that's normal - he's an odd duck." This was typical for situations when the Techs would suggest changes to something - they may suggest, but the "Great Man" made all the decisions - and as a true testament to his greatness, he always listened & discussed before rendering it.

Enter Emory into the practice management:

I went in for a periodic download w/ the MFGR's Rep in Oct 2014. I was greeted, not by the Rep, but by Laurel & hardy; Abbott & Costello; Spike Milligan & Red Skelton, (or was it "Heckyl & Jeckyl?) masquerading as the Rep. They came from the central Cardio PM section 50 miles away in downtown to check all the PM's on the schedule for the day, regardless of manufacture. IMNSHO, I could interpret the report better than they could. After they begrudgingly gave me my copy of the report, I could see why they hesitated - they could not answer a single question I asked. Worse, I don't see my Cardio till 3 April - months after the report. This is going to be interesting.

My feelings on this parallels those of Inga & The Knot Guy. I really don't want anyone saying "OOPS!" after changing something they are not intimately familiar with. Three examples I am familiar with:

1) A Cardio, when discussing Nefedipine ER, a med for controlling BP w/ me. He says "If it is giving you uncomfortable side effects, just break it in half & take the two pieces separated by several hours." At that point, I realized he was incompetent - that med was a pill w/ two separate sections w/ a membrane between them. There was a small laser-drilled hole in the outside of the shell permitting the med to be metered continuously for 24 hrs. The med had a "BLACK Box Warning" about NEVER cutting as pill or you would essentially OD.

2) A GP gave me a prescription that looked different from the previously given one. The med was different by one letter in the name. He had written a note to the nurse for the Rx & she printed it out from their computer. On the way out, I proof-read the Rx, walked back in, collared him in the hall & asked about it. He choked - the wrong one listed on the Rx could have killed me had I taken it.

3) I was in living in London on an 18 month assignment. I recall at least THREE times my miserable Bod was saved from destruction by a double-decker bus when I was about to step in front of it off the curb. In each instance, a local citizen grabbed me by the shoulder & pulled me back, saying, in each case "You're a Yank, aren't you?". I had looked the WRONG direction before stepping off the curb (I know, Ian, it's spelled Kerb). One of our nations drives on the wrong side of the road & that unknowingly programs us to look the wrong way when visiting one another.

4) Mac's vs PC's. You scroll differently w/ the mouse. One moves the page UP while scrolling, the other moves it DOWN.

5) Location of controls on machinery - particularly aircraft. A lifetime ago, I read an accident report from a fatal crash on landing during foul weather. It was attributed to a pilot flying a plane that he was certified ("Checked out") to fly, but had the two throttles located overhead, as opposed to between the seats on a floor pedestal. Under the stress of the flying conditions, he reached to the wrong location. The plane crashed.

6) I also do not want a foot surgeon performing brain surgery on me.

Donr

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