Medtronic Advisa A2DR01 settings

I had a Medtronic Advisa DR MRI A2DR01 implanted in Nov'15 due to bradycardia & heart block events during runs. After beginning running again in Jan'16 the pacemaker (or maybe my natural heart function) did a great job of maintaining around 140+ bpm throughout 40 to 50 minutes runs. Then, in Mar'16 my heart began blocking again at 20 to 30 minutes into the run (from 140 to down below 120 bpm) making further running anaerobic. Yesterday my Medtronic rep evaluated and turned "Rate Adaptive AV" from Off to On and made the following settings:
Upper Sensor Rate - 160 bpm
Rate Adaptive AV Start Rate - 90 bpm
Rate Adaptive AV Stop Rate - 150 bpm
Min Paced AV - 140 ms
Min Sensed AV - 110 ms
I'm no medical professional, but this reset seemed to me (and the rep) that it would fix the blocking problem. However, today my heart blocked at about 20 minutes into a run and at about 130 bpm. Do you have any ideas pertaining to the settings made to the Rate Adaptive function. (Or, are there other functions in the pacemaker that could correct heart blocking?) Also, during this past month my average resting heart rate has declined from above 60 bpm to 50 bpm. Perhaps the overall sensitivity of the pacemaker needs to be increased. I would much appreciate any ideas. Thank you!

2 Comments

Medtronic Advisa A2DR01 settings

by frankmcw - 2016-04-08 05:04:08

Thanks for your comment. The settings I listed above were only those in the Rate Adaptive AV function. I checked my printout from my latest session with the Medtronic rep and in the general settings the Upper Track was already set at 160 bpm. Within the Rate Response section of the printout I see another list of settings:
ADL Rate - 95 bpm
Optimization - On
ADL Response - 3
Exertion Response - 3
Activity Threshold - Medium Low
Activity Deceleration - Exercise
ADL Setpoint - 46
UR Setpoint - 73
I have no idea what those settings do, but it seems like one of the settings, somewhere in the pacemaker, would be designed to maintain an exercising heart rate (above 130 bpm) for an extended period (more than 40 minutes). Thanks again.

Tracking Rate

by BillH - 2016-04-08 12:04:18

One number is that not mentioned is maximum tracking rate. With your numbers I would have assumed that it was set to 160 or more. But it is possible that it was missed.

Also some PM have the option to make a recording to see what the rate response is doing doing an activity. That would allow them to see if that is causing the problem.

For your next adjustment you can arrange to run immediately before so that you are still in that state.

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