atrial lead programmed off

hi.
am new to this but here goes ,
I had a pacemaker first fitted in 1996 for eleven episodes of nocturnal ventricular standstill , as I had unconsciousness, however I had further unconscious episodes even though I had a pacemaker implanted ( was this justified giving me a pacemaker in the first place ).
Reason I ask is because pacemaker had to be changed in 2006 and now its for complete heart block narrow qrs, I was told by a technician that base rate was set higher than it should be and re adjusted it accordingly, it was set at 60bpm adjusted to 50 bpm, it was noted later that my heart was saying it did not need pacemaker assistance and wants to work on its own.
this no doubt was discussed with the consultant because the next thing I knew I was transferred to a junior technician but the atrial lead rate response was programmed off , this tech was not informed of this action and suspected a broken lead , he has noted on the info he can see is that my heart is immaculate.

can anyone advise me here are they trying to hide the truth, cuz the original condition was not believed by an instructed cardiologist anyway, my original symptoms pointed to neurological .
thanks for any constructive reply..

4 Comments

The truth

by Good Dog - 2015-02-08 07:02:05

I really think that your question can be answered "only" by another cardiologist. If you can't trust your original doc to give you a straight answer, then find another that practices in a different hospital/network.
You need to have your questions answered so that you have a full understanding of your condition/treatment. Your current doc is best to do that, but there is nothing wrong with getting another opinion.

I'm confused

by Tracey_E - 2015-02-08 07:02:21

If you have block or ventricular pauses, you don't really need atrial pacing so if the lead is not working properly, it would be appropriate to turn it off. Bad leads can kill the battery life so the idea would be to turn of an unnecessary function to preserve battery life until your battery needs replaced. Leads last on average 15 years so your lead life was decent, if that's what happened.

Adjusting from 60 to 50 would be an atrial setting, not ventricle, so it theoretically should not affect you unless your natural resting rate is in the 50's so it was pacing unnecessarily. Most people have a resting rate higher than that so, having a pm set at 60 or 50 wouldn't make a difference because it would never kick in. If the atrial lead is turned off, it doesn't matter where it's set because it won't kick in anyway.

How much do you pace ventricle? If you have block- where the signal does not make it from the atrial to the ventricles- one would expect to pace quite a bit. Complete heart block, by definition, is all the time, so most of us with CHB pace every beat. Sounds like that's not what you have.

If you have pauses, such as 11 in however long your test was, your numbers would statistically be very small because it's only pacing a few beats at a time. Just because it's statistically a small number, and many reports will say less than 1% is 0, doesn't mean it's not kicking in and doing an important job. At 60 bpm, that's 3600 an hour, 86,400 beats a day. 1% of that is 864. If you have one episode a week, say it paces you 10 beats to get out of the episode, that's not going to show up on the report as significant, but those ten beats got your heart going again.

Have you had a tilt test? NCS can cause pauses, it can be neurological, cardiac or a combination of both. If it's both, the pacer is appropriate however you'd need to also treat the second half of the problem. Whether the CAUSE is neurological or cardiac, the EFFECT is your heart stopped so the pm would be appropriate either way.

Most of us with electrical problems have perfectly healthy hearts. They're structurally normal, the arteries are clear, they just have an electrical short circuit.

Can you get another opinion? You need some straight answers.

atrial lead off

by davey - 2015-02-09 10:02:49

hi traceyE
thanks for your advice , but just to let you know my pacemaker is in sense mode and as far as im aware the ventricals are not being paced , i know this all sounds bizarre but i feel that the pacemaker was fitted purely as a deception from as said before a neurological problem called a focal seizure caused by a prescription drug high dose ibuprofen, my present hospital have stated that what i had a pacemaker fitted for in 1996 episodes of ventricular standstill i never had in the first place , but there is a blip there, when i asked where is this blip they said it is on the pr interval but two technicians have not seen this so called blip , they know that i am considering private tests and advised against it saying it would be life threatening thing to do, blip whatever this is does not kill and i said i would still go ahead regardless of risk they backed down and then said tests in fact wont show anything and would be waste of time and money, blip may not show up for ten years.
this case is in england and i am going abroad cuz the british nhs covers up , can you advise a decent hospital that will give me the real facts, do i have anything or not which is it .. thanks for your input.

device in vvi

by davey - 2019-06-05 20:17:34

Hi all, 

Yes im still here and trying yes trying to get to the bottom of things, im going through my pm reports, and as im in VVI i notice the following information.

 

There is a box which shows Ventrical sense, >99%

and next to it it shows Ventrical pace <1%

any idea what this means, 

I have heard that the device Merlin Identity 5386 ADx does not evaluate to 100% or 0%.

thanks , hope someone can advise.

 

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