Medronic A2DRO1

movement

by Tracey_E - 2018-09-12 21:17:39

Why did you get the pacer? If you don't have sinus dysfunction, you won't need the pacer to get your rate up for you. With av block, the sinus node works normally so all the pacer is doing is playing follow the leader, making sure the ventricles stay in sunc with the atria. If your sinus node needs help and you'll be using rate response, then your arm movement will tell the pacer that you are moving and it should raise your rate. No two of us are alike so settings are individual. What gives me enough of a boost to support activity may or may not be enough for you. It's not uncommon to take a bit of trial and error to get the settings fine tuned. 

Movement

by AnnieMac - 2018-09-12 23:18:29

Tracey, yes I do have sinus disfunction -"sych sinus" - which is why the pacemaker was placed.  My cardiologist and Medronic tech did a superb job 'tuning me up' to hike.  However, I was trying to understand how the pacemaker would detect movement and respond to swimming.  I am also concerned, that if the pacemaker is working well for hiking, changing it for swimming might be detremental to hiking.  Having been athletic and active all my life, it is quite a learning experience to work with a computer pacing you existance!  I find myself almost wishing I had a remote control for the pacemaker that would enable me to make some changes on the run so to speak. ;>)

"Sick" Sinus Syndrome

by AgentX86 - 2018-09-13 08:33:37

It may be difficult to tune your pacemaker for both running and swimming. The motions are quite different for the energy expended. St. Jude's, as I understand it, has a micro-breath sensor that is supposed to measure your lung function, which is a better, if indirect, measure of energy consumption. Medtronic, AFIK, doesn't have anything like it.

The sinus node responds to CO2 levels in the blood. Since you have SSS, your sinus node may, or may not, be able to respond. Your EP should set your pacemaker accordingly but if you sinus node is completely dysfunctional,  I don't think it's going to be easy to set up a Medtronic PM to sense both running and swimming well.

BTW, I too have a Medtronic and see my EP tomorrow.  I want some adjustments made that may not be possible,  so I'm sure I'll learn more about what's possible with a Medtronic then.

balance

by Tracey_E - 2018-09-13 09:57:14

You're probably going to have to experiment to find the best balance. Hopefully they can find something that works for both activities. Sometimes we have to compromise. Mine is set to jump up fairly quickly, which is great at the gym but it means I get short of breath pretty easily walking across the room. When it was less sensitive, I struggled at the gym so I chose to have it this way. 

Minute ventillation is when the rate response goes by breathing as well as motion, but I'm pretty sure Medtronics don't have that. I could be wrong, tho, I have SJM which is just motion. I think Boston makes the ones with minute ventillation and Sorin makes the closed loop stimulation, which I can't even begin to understand much less explain. It somehow learns your habits.  

Tuning Pacemaker for Two Different Sports

by AnnieMac - 2018-09-13 16:12:03

Thanks AgentX86.  Let me know how your 'tune up' goes tomorrow. 

Tracey, they have set my pacemaker to zoom up when I stand and move (70bpm to 105 bpm) which is great for getting around and may just work with swimming - at least initially.  After all this hospital and recovery time, I will have to get in shape with the swimming and there will be a lot of demand on me on the first lap.

Tricks I leanred from my Medtronic rep for tackling hills on the hike that maybe helpful to you in just moving is to stomp your feet rapidly in place for firve or six times and/or physically tap your pacemaker with your fingers.  It will respond in one second by increasing heart rate.

I find it disappointing that these pacemakers do not know altitude or ascents or descents.  My sports watch certainly does and there are even smarter apps for the smart phone.  Wonder when they will put this technology into PM's????

Gadgets

by Tracey_E - 2018-09-13 20:23:19

top of my wish list would be the ability to have two settings and let me switch between them, only turn on the aggressive settings when I need it  

Im sure the technology could be there to be more sophisticated but 1) most patients don’t use them as hard as we do so there is limited demand and 2) settings are a prescription. Would be nice, though. 

Rate response

by AgentX86 - 2018-09-13 22:48:37

I do a lot of walking and my PM doesn't respond as I'd like (the bottom line for my tuneup requests tomorrow).  I walk about 100-110 miles a week, about half on a treadmill at some fairly steep inclines to exercise my leg muscles to exhaustion (I could probably walk forever on the flats).  The problem is that my heart rate never gets about 105 and I've brick-walled (115 would be nice).  I'd like a quicker response, too.

I'm not sure it's a good idea to expose any PM controls to the user.  Exposing these controls would be a really big target for hackers.  Of course there is one control the user has access; the MRI magnet.  ;-)

Multi Sport Settings

by frankmcw - 2018-10-02 02:55:15

AnnieMac & AgentX86, I also have a Medtronic A2DR01 installed and after 3 years have found settings that will work well for running, hiking, bicycling, swimming, walking, gym workouts and more. My initial settings were good for running but not too effective for my other sports. (The accelerometer in our Medtronic responds well to the physical jogging of the upper torso during running.) For the accelerometer to pace your heart rate high enough for most other activities the sensitivity needs to be increased. These are the settings that need to be made to accomplish this: 1.Make sure “Rate Response” is ON      2.Increase the “ADL Rate” to about 115, from the factory setting of 95 then,    3.Turn “Optimization” OFF     4.Set “ADL Setpoint” to 10 or 15 and     5.Set “UR Setpoint” to about 120.     I worked with a Medtronic technician in the Phoenix area who made similar settings for other athletes who were having the same issues we have. Run this by your Medtronic technician (not your cardiologist, this is not his area of expertise). He should be able to make these changes. He may be resistant to making all these settings changes at once, however, the goal will not be accomplished unless done all together. You can test the results immediately by duplicating the excercise you want on the spot. You will find your heart rate being paced higher much more easily than before, and it will stay higher throughout your exercise. By the way, tapping your pacemaker before an exercise will not help at all, as you would have to tap during the entire workout. If you want more technical information about how these settings work I can send more information.