Rate Drop Response

Hello!

I have ADVISA DR MR SURESCA A3DR01 implanted 3 months ago for intermittent AV block.

About a month ago I had another post here complaining about sudden heart speed ups that went to around 100 bpm for a couple of minutes every time after my last checkup visit. That turned to be Rate drop response. So, some settings changed and that made me feel better. But I still get some episodes during night time and I was wondering if my parameters are appropriate.

So these are my parameters:

Lower Rate: 50 bpm

Detection Type: Drop

Drop size: 25 bpm

Drop rate: 50 bpm

Detection Window: 1,5min

Intervention rate : 100bpm

Intervention Duration 2 min

 

I think Detection Window is too long and could be changed to smaller but not sure!

Also I do have a question about Lower rate. Is that the base lower rate so my lower rate is set to 50 bpm? I remember my doctor saying that my lower rate is set to 60. But the technical said that my lower rate is 50 when checking the Rate drop response screen.

On the other hand the on the pm manual is written that when Rate drop response is on the lower rate is automatically set to 45 bpm. I am confused about that.

Any opinions? 

1 Comments

RDR (Rate Drop Response)

by Gemita - 2021-02-25 14:44:40

Some of us are very sensitive to sudden heart rate drops, especially when they are significant, and this clever little feature can step in and help us out when it is programmed On.  RDR will kick in after certain parameters have been met and increase our heart rate for a certain duration of time to help stabilise us during a period of a sudden fall in heart rate.  

The RDR measures how fast the HR is dropping and takes over faster, protecting us from these sudden (in some cases massive) falls in heart rate which could destabilise us.  That is the theory, but the RDR settings need to be managed effectively to suit our particular needs.

Mtheo, this is complicated stuff for the EP/technician to deal with, and trial and error with the RDR settings I would imagine.  Have you read your manual for your model of pacemaker, the section on RDR which will explain all about this feature?   Sorry, I see you have.

I do recall your earlier post and thank you for the update.  I am glad you have found the cause for your heart rate increase, particularly at night, which would appear to be RDR generated.  

I see you have a Medtronic pacemaker, like me.  I do not know whether my RDR is "On" so you are well ahead of me.  Looking at the Medtronic Academy link (below) the detection window is set at 1 min.  I see yours is set at 1.5 min. Secondly maybe check whether your sleep function is programmed On if undesirable symptoms occur due to RDR intervention. Programmed On disables RDR during sleep times and that might help, although if you get rate drops during the night, they won’t be managed.

https://www.medtronicacademy.com/features/rate-drop-response-rdr-feature

As you are very sensitive to increased heart rate, especially at night, I wonder whether the Intervention Rate of 100 bpm can be safely reduced to say 90 bpm to still protect you from a significant heart rate fall by pacing you at this higher, but reduced rate for the duration set.  Might be worth asking your doctors about?  Perhaps the Intervention Duration time could be reduced too?  These are the questions I would be asking.

Looks as though your Lower (Base Rate) is set at 50 bpm, whatever you have been told.   You might question if this rate is too low for you?  I know many members are set at 50 bpm, but anything under 60 bpm would be classified as Bradycardia. 

The lower rate of 45 bpm seems to be a "programming" rate for RDR with ICD's and Advisa pacemakers (see Medtronic Academy link).  Hopefully your doctors will be able to fine tune your settings so that they are right for you.  Good luck

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