Paced AV set to 300ms

My husband had his pacemaker implanted in 2009 and everything has gone well, or so we think (according to the Medtronic technician). Around the 15th of April he felt chest tightness and hoping it would go away on its own, didn't do anything until.... the 19th, we were going shopping and ended in the ER. He says he felt as if he were going to pass out and for a moment he felt disoriented. They thoroughly checked his heart, his cholesterol, his BP, for any blocked artery in his neck, and his lugs. The results did not show anything wrong, however, when the Medtronic technician came over to test his PM, made some changes (which he declined commenting on), and when I asked how everything looked, his answer was: "It's transmitting garbage". I then asked him what he meant by "garbage" and he just gave a short explanation, meaning that his heart was having premature ventricular beats. While going through the PM tests, my husband expressed that he could feel a BIG difference and started to feel better. Anyway, the technician left the room and his final report read that he "made some adjustments and the PM is working properly now". The nurses at the hospital said "that's all they got from him". My husband felt much better since then, although he was still having those episodes. The people at Medtronic INSIST it is NOT the PM. If not.... why did he feel relief after the adjustments? We went back to the Medtronic office to a face to face checkup and the PM showed he was pacing 29% of the time after his usual being 2% (an increment of 27%). The technician changed the Paced AV from 180ms to 300ms and the Sensed AV from 150ms to 270ms and told us to give it a week to see if he noticed improvement. She added that she could even increase the interval further if necessary. Again, he has been feeling much better -still an event once in a while. This morning he had his PM interrogated, which showed he was pacing 9% of the time and asked for an appointment to have the AV increased to 500ms at least but the technician (a different one from the one who made the latest adjustments) said they could not increase it, that 300ms was the most they could do. One more time, she insisted it IS NOT the PM. Can anyone explain the contradictions?
1. After every adjustment he feels better and
2. The interval can be increased and then they said they couldn't.
It has been a puzzle and we feel like nobody listens. Medtronic says something different depending on who's turn it is!

4 Comments

Yes, sounds confusing

by doublehorn48 - 2015-05-05 08:05:33

I've had a medtronic pm for 25+ yrs. A few things I've come to believe.
1. All technicians aren't equal. They should be, and be able to set the pms the same. But, in my case they are quite different. While one will explain what he or she is doing, another one cannot or won't explain. And one will set the pm and I will have no problems, while another one sets it, and I'll be making another appointment to "tweek" the pm.
2. Some people have good luck when contacting Medtronic, I don't.
3. It isn't your fault they don't explain what garbage is. It is the techs job, as far as I'm concerned, to explain what they are doing for your husband. God bless.

Pacemaker set at 60bpm

by Andcunn - 2015-05-06 05:05:29

Thanks for your comment. Now, my husband has been taking his BP along with his HR and while the BP is within his normal range, his HR has been 80 bpm three times in a row while resting. His HR used to be 45-46, which was fixed by implanting the pacemaker set at 60 bpm. I wonder if this information is recorded during the interrogations or if the PM is sending wrong information (since they keep saying the pacemaker is doing its job). Is this possible? Could it be set at 80 bpm and their equipment shows 60? Again, just wondering and hoping someone comes up with suggestions and/or enlightens us.

you need to ask for your interrogation reports

by primaldiva - 2015-05-11 08:05:21

Ask for a copy of your Initial Interrogation Report and your Final Report before you leave the office. You are entitled to them. It's hard to tell what's going on because I am not sure what your husband's issue is (his diagnosis for getting the pacer in the first place) but in my experience doctors and reps will ALWAYS deny that there is anything wrong with the device or settings. Also, is the 60 bpm a lower limit setting? If he is only being paced 9% of the time I imagine it is?

Bradycardia

by Andcunn - 2015-05-14 01:05:47

Thank you for your comment, primaldiva. Next visit I'll ask for the full reports from his last three appointments. The reason for his pacemaker is bradycardia. His heart rate was usually 45ish and didn't use to bother him (at least he was not aware of it). The 60 bpm is the lowest limit setting for him and the doctor made it clear that he would not depend on the pacemaker. What you say is true about docs and reps ALWAYS denying there is anything wrong with the device or settings and we went through that just the past week. While one technician told us to call on Wednesday so she could increase the Paced AV, the one that answered the call said that that was not possible. She said she had called the first technician (the one that offered to increase the Paced AV) and according to this one, she NEVER said that. I even told my husband that next time we will record EVERYTHING they say and if ANYTHING goes wrong we would start a lawsuit against Medtronic. He is still having those uncomfortable events caused by his heart rate abruptly jumping to 80 bpm. Why not 81 or 83 or 90...? Is this due to the pacemaker settings or programming? I'm carrying an oximeter with me all the time and when he says he "is in 80", I measure his pulse and guess what? His HR is 80 bmp. Not 75, not 82, not 85 not 90, not 92... but 80! While he is active his HR can go even higher and it doesn't bother him. But while resting, his HR jumps to 80 and he feels the pressure on his chest. I am trying to convince him to look for a second opinion and even have his pacemaker changed. Still a puzzle...
Open to more comments, advices, ideas... Thanks in advance.

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