New settings!

I had a CAEP test today with the device rep to see about fine-tuning to improve exercise output and endurance. Mine main issue has been cycling up hills, but I also have plateaued on jogging. He seemed quite impressed that I made it to the end, with a treadmill speed of about 5 mph. He plotted my data to give a graph showing that with the new settings I am right where I ought to be for exercising. 

He made a few tweeks: increased my upper rate from 140 to 155 and turned on some sort of feature that allows a change in the AV setting, so that it narrows when my heart rate increases. It turns out my device doesn't have MV capabiltiy, which he indicated would be the best way to accomodate hill climbing. Oh well. And he made a change on my LV lead which will hopefully lead to less phrenic nerve stimulation. I'm not sure that was a good idea, because even though my belly isn't twitching, I can feel something is different. 

And the rep was willing to answer lots of questions that others have just sort of brushed off. I found out that I have intermittant flutter. Also when I am in a Flutter, or a fib, the low rate setting  is 70 to accomodate for loss of atrial kick. I can feel atrial arrhytmias and I wondered why my heart rate was higher then. He also interpreted some of the info from past interogation reports. 

He said that most people don't care about that stuff, but I think from reading this forum, a lot more care than he realizes. 

4 Comments

Sounds very encouraging

by crustyg - 2021-05-28 02:58:22

The device reps usually know their stuff - the vendors train them well.

It's a fine line for them to tread, working out who really wants to know more (and having a reason why) and overloading those who have no interest or understanding of the principles which would make a lot of the explanations unintelligible.

We've seen a number of contributions here where newly implanted folk ask 'What questions should I ask my EP-team', and generally the responses are to focus on living as well/actively/normally as possible and if that turns out to be limited by the PM tech or underlying heart condition then that should inform the questions.

And like almost anything in life, the more you know and understand about any area of interest, the more likely that you'll be able to ask 'better' questions.

I'm pleased for you, and thank you for sharing.

CAEP TEST (Chronotropic assessment exercise protocol)

by Gemita - 2021-05-28 03:44:15

Julros, thank you so much for your helpful feedback.  Quite incredible what you achieved during your CAEP test and gives me lots of information and encouragement for both myself and my husband.  Would be interesting to see the before and after settings, although appreciate they will be adjusted for you personally.

Your post confirms how important it is to find the right technician to work with.  What a difference it can make to the outcome. 

How interesting about the higher rate of 70 bpm setting during intermittent FlutterAF to help with the loss of atrial kick.  I wonder whether mine automatically increases from the base rate of 70 bpm during an atrial tachy arrhythmia to help.  There is so much we don't know about our settings. Was the technician able to answer whether your AF is increasing or did you ever find out?  Sorry to hear about the intermittent Flutter, but AFib and Flutter are often seen together, or one might just lead to, or unmask, the other at some stage as I discovered.  

What would be interesting Julros is if you could kindly share your new settings with us, particularly the AV setting changes if you know them because I have read many are struggling here to understand them including me.  I appreciate they will be individualised to suit you but even so, it might give other members some helpful info. 

I see you have had a lead adjustment for your phrenic nerve irritation.  Hope this settles and improves things for you without triggering other problems.

Settings

by Julros - 2021-05-28 12:22:02

 

Gemita, the change in settings hasn't been posted in the portal yet, but when they are available, I will share them. I forgot to ask about increased episodes, but I see doc in July and will ask. I don'tthink  episodes are increasing in frequency, but more in duration, and usually at night. I have been trying to eliminate my nightly glass of wine, because I know that alcohol can be a trigger. And I need to work on meditation.

Encouraging information

by Persephone - 2021-05-28 17:39:48

Thank you for sharing this information, Julros - your enthusiasm about your progress and your efforts to continue to learn are very inspirational!

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You read consumer reports before upgrading to a new model.

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The pacer systems are really very reliable. The main problem is the incompetent programming of them. If yours is working well for you, get on with life and enjoy it. You probably are more at risk of problems with a valve job than the pacer.