Rate Response

Rate Response

by Gemita - 2021-05-21 16:23:32

Hello Michelle,

Thank you for the update and I am really glad you have got some positive feedback from your clinic.  So you were hitting your roof and causing skipped beats which resulted in your symptoms?  By increasing your upper limit this shouldn't happen again, but keep an eye on it just in case.  And of course you could always ask for a treatmill test to test yourself under pressure and get those settings optimised for you.  Just an idea for the future Michelle if you continue to have problems.  You were brave to challenge yourself again but I am glad no harm came to you.

Gemita

Rate Response

by Ms Rutledge - 2021-05-21 20:46:21

Gemita, from what the tech said she felt as though that is what caused the problem.   She said since I was over the rates that were programmed I was most likely skipping beats, keeping the rate response from kicking in.  She had the transmission.   So she is having me come in Wed. to change the settings. I I took your advise and did an ECG recording.  I am going to print that out and take it with me as well.   I really do not know what all appears on these transmissions.   I am not sure if it showed skipped beats, or if that is most likely the problem. There is so much I do not know.   Oh believe me I am not brave, the EP  told me I needed to work out as hard as possible.  Lol.   Thanks  again for all of your advise.

Yes it is a real Study

by Gemita - 2021-05-22 01:46:02

Hi Michelle,

Yes like you I do not understand my ECGs;  a few things, maybe, but it needs further study.

I am really glad you were able to record your experience.  A trained eye should be able to interpret what it all means, providing the recording was of sufficient length. Sometimes a short strip recording, however useful, can be difficult to fully assess.  Although Apple watch/Kardia Mobile may not be fully tested for accuracy in recording "paced" rhythms, a good cardiologist should have no trouble interpreting a paced ECG from these sources.  The fact you were told to push yourself as much as possible is a good sign that your team are not concerned for your immediate safety and this reassures me.  I hope any future settings changes will work well for you

Pacemaker transmissions

by Gemita - 2021-05-22 08:37:59

Sorry Michelle, I missed your question on the subject of “pacemaker transmissions”.  I was focussing on your home monitoring ECG recordings using Kardia Mobile/Apple Watch.  

My understanding is that your actual pacemaker transmissions will give your clinic medical and technical information from your heart where they can look for any changes that might have occurred since your last transmission with either your heart rhythm or with the implant.   Although they cannot adjust your settings “remotely”, they can see if they are causing problems and whether the leads and battery are functioning as they should.   If they see anything worrying, say an event like a fast ventricular arrhythmia or a problem with your device, it will be flagged and they would immediately get in touch with you to speak about any symptoms or any action you would need to take (like increase medication or visit a hospital).

From personal experience when I have had problems with Atrial Fibrillation with rapid heart rates and sent transmissions to my clinic, these high heart rates were highlighted on my transmissions several times and triggered an immediate response from my clinic who told me to call an ambulance.  If anything significant is seen, you will be informed Michelle.

So to conclude, our downloads will give our doctors lots of information.  They would be able to see how well any arrhythmia was responding to medication, to pacemaker settings, how active we are from any heart rate logs, whether we had arrhythmias that were not adequately treated, even whether we had electrolyte disturbances or some other medical condition, like hypothermia.  It is quite incredible what they can pick up from a monitored, paced ECG, although clearly it will not be as complete or as useful as an actual, in clinic, surface ECG.  Home Monitoring allows your doctors to detect any significant problems early giving them plenty of time to intervene and to prevent a serious event from occurring.

Of course our pacemakers need to be programmed for our personal condition, to give our doctors the information they really need from our downloads.  If the parameters set up in the pacemaker have not been met for an event to be recorded and reported on, they may not be (for example an arrhythmia may need to be for a certain duration and at a certain speed before it is specifically flagged and recorded.  Anything significant would not be missed however.  The not so significant stuff (like your skipped beats) may still therefore need some additional external home monitoring to get the full picture, since pacemaker storage is limited for essential information.  Clearly though they saw your skipped beats on your transmission and were able to rule out anything more serious