Annual Pacemaker Check

How it works in my Cardiologist's office...

by Lurch - 2017-10-17 21:04:54

My Cardiologist did not implant my ICD, he sent me to an EP for that.  However, now, twice each year, I visit my Cardiologist's office where the Device Tech (an RN in his office) checks my device and settings.  She forwards the information to my Cardiologist for review, but when it comes to how the device functions and the settings, she, the Device Tech, is the go-to person.  

My ICD was implanted three years ago and I have been back to the EP only once, one week after implant. 

My Experience

by Peter P. - 2017-10-17 22:20:28

I too, have a remote device through which I upload my pacemaker twice a year.

When I went to my first pacemaker checkup "clinic" I thought it would be a big deal, or at least a one-to-one visit.

Instead, it was like a production line with a roomful of customers. There was a tech and a factory rep there. They uploaded my readings, told me of the remaining battery life of my pacemaker, and I was out of there in 90 seconds or less! I was dumbfounded. Made me wonder what the difference is between my remote upload and the "clinic". I felt it was just a profit making scheme.

Annual checkup with technicians

by LondonAndy - 2017-10-18 03:51:54

I don't have a remote Merlin type device, and just go for the annual checkups, which are with technicians - usually seems to be two of them, though I have only just had my third annual check, as I posted last week.  The visit lasted about 10 minutes. They do things like lower the rate of pacing (I am 100% paced, with the minimum set at 60bpm. They drop the rate to 30bpm to see if my heart initiates any beats, and also check that the rate response will increase to higher levels too.  They review the readings since last check, and ask about how I have felt etc, and monitor ECG readings during the check)

They are obviously specialists, and a key part of the purpose is to make sure the device is working properly, so better for specialists to do this.  They are competent to adjust settings of course, and can report things like tachycardia or any other new developments. 

Checkup

by doublehorn48 - 2017-10-18 16:33:19

Had my annual checkup yesterday.  The tech did the interrogation and then I saw the Cardiologist. The tech gives the info to the Cardiologist and he/she explains what the data means.  As far as I'm concerned, if you don't see your Cardiologist you are getting shortchanged.  I always come away from the Cardiologist with a new perspective of how I'm doing with the pm.  I look forward to the Cardiologists' comments.

Pretty sad commentary...

by donr - 2017-10-21 09:12:49

...on what cardiology has come to!  IMNSHO, there's more to it than checking out the device annually/semi-annually/whatever. 

The Heart & PM/ICD make a system where the two "Devices" interact w/ one another.  Neither one of them is perfect - the heart, because it is a biological device, non-linear in its actions/reactions.  It also is adaptive and has many characteristics/capabilities that are still not fully understood.  It is semi-autonomous, being independently driven from its own Sinus node, while being susceptible to influence from the brain and the adrenal gland.  Any one of the 5 senses can cause it to accelerate like a race car.

Look at the history of the development of PM's.  They started out as rather clunky devices with limited capabilities - principally only capable of treating Brady at a fixed rate.  They have been miniaturized, optimized, algorithmized, adaptive, re-programable, everything but Pasteurized.  But it is still an enlectro-mechanical device, whereas the heart is an electro-chemical/biological/mechanical pump device.  It takes an electrical engineer to completely understand & run a complete diagnosis on one & a physician to understand  & run a complete diagnosis on the other.  My current EP is an EE turned EP, so I have the best of both worlds checking my PM.

When you get to the PM stage in your life, your native heart has already demonstrated that it is fallible - it has failed you - electrically.   The PM is far more reliable - short run of about ten years - than your heart.  Therefore, the heart now needs a bit more checking than before the PM arrived on your personal scene.

Whoopsee! One minor detail I forgot to mention - the two devices are interconnected by the LEAST reliable part of the system - the leads; one to three of them.  One of the major problems facing us through leads is their susceptibility to failure through mechanical fatigue from constantly being whipped around in the turbulent flow of blood; the second is corrosion due to ther harsh chemical environment they are immersed in.  Throw in the difficulty of getting them implanted securely and correctly in the constantly moving walls of the heart and you have an interface fraught w/ opportunities to fail.

For either of the two technical sides to shirk their duty to their patient is bad news.  Beyond the failure to treat the heart/PM system, is the failure to properly treat the human mind part.  That this thread exists at all is due to a failure to treat the mind.  Napoleon said it all in about 1806 & I will repeat it here - "In battle, the mental is to the physical as three is to one!"  The same is true in the medical field, & especially in matters cardiac.

Donr

See dr

by Finn - 2017-10-27 19:48:16

yes, technician checks your device but dr always reviews with you!