Good Adjustment

Have been having trouble since an adjustment made in the delay time of my PM in mid-December. After having sent some data to the device clinic I see, my EP's nurse had an appointment made for me to go back in sooner than originally planned. That appointment was Friday Dec-30. My PM was originally operating 2.8% of the time in the bottom chamber after my 2 week appointment and so they had increased the delay time by 40 milliseconds. Following that I was feeling short of breath and weak walking from my car to my house or up one flight of stairs. (I'm an active 25 year old, so that was pretty drastic). 

On my Friday appointment it showed that even with the increased delay my PM was operating 68% of the time for the bottom chamber now. When turned off I am in complete heart block all the time, I was experiencing 2nd degree heart block during exercise when I got the PM. They shortened the delay time back to its original setting and I was then able to run up and down the hallways of the hospital. I've been full of energy since Friday too (was lethargic before). Feeling pretty pleased about it. 

My EP did let me know he was hoping the adjustment would be all that was needed but stated that my heart could potentially be in a state of decline (I had a tricuspid valve replacement in July). That it was something to look out for and to look out for swelling of course. After weeks of feeling terrible physically it was not mentally shocking to hear that. It was something I was worried about hearing before I met with him. He said that this sometimes happens with patients, that following the first 2 weeks the PM starts being used more often. Anyone else have this, a jump similar from 2.8% to 68% after the first 2 weeks? Is this increase an indication that my heart is declining?

2 Comments

AV delay setting

by WillieG - 2017-01-03 13:58:10

Like you, I have experienced an amazing difference in ventricular pacing % with a change or just 30 ms in the paced and sensed AV delays.  I have second degree AV block and had my PM implanted in June of 2014 when I was 61.  I had zero pacing for the first 9 months and below 7% the following year.  When they turned off the AV Seach + (which is used to save pacing) and lengthen the delay, I did not feel good exercising. So they shortened the AV delay and I felt great for 4  months.  Then I was shocked when I saw my interrogation results from the remote report that said I was pacing 100%!  So they lengthen the AV delay just 30 ms and checked me in a month.  I was down to 38%!  I felt the blocks during the beginning of spinning and walking uphill and was out of breath.  Interestingly, I have adjusted over last three months and feel fine.  Doesn't seem very "scientific" that you get used to the change, but I did.  Also, when on a trip where I didn't do my normal exercise, when returning to it I felt out of breath but after a couple of weeks, felt OK again.  So perhaps give yourself some time or maybe get the device clinic to shorten a small amount and see what happens.  I will be curious to see how you feel.

Good Luck!  

WillieG

by Ncrespo3 - 2017-01-04 12:47:57

Thank you for the story and information. I'd have to agree with that thought that it doesn't seem very "scientific" but am looking forward to possibly getting used to my recent change. Thank you again. 

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