TO ELECTRIC FRANK AND EVERYONE ELSE

I have a Biventricular pacemaker with only two leads fitted, pacing both ventricles. I have no AV node ( it was ablated ). I have permanent atrial fibrillation. I am therefore 100% pacemaker dependant. This was done in 2007.
My question is this- I am doing very well , better than average for this condition. However I have in recent years become convinced that I would be far better off if the MOTION DETECTOR in the pacemaker was turned off . My minimum beat rate is 70 BPM and I think the maximum is 120 BPM ( Pacemaker settings ).
When I am at rest or not moving my heart ( which has remodeled itself to the new status quo quite well ) is at 70 BPM. After an hour or so I get a really strong pulse at my wrist and I can feel my pulse without feeling it in my fingertips. This never happened even when I was a young and foolish !!
However if I exert myself ( go on a two mile walk for example ) therefore increasing my pulse rate , my pulse gets extremely weak and to all impressions non existent and I dont fell quite right. I am incresingly convinced that I would be better off if my motion detector was turned off in my pacemaker. I would also get more life out of it maybe an extra 6 months from new. What do you think? I do know someone who has had his turned off and is better off for it. All comments very welcome. Peter ( Aged 65 )

3 Comments

My RR is off

by Mary1998 - 2012-06-24 01:06:51

I have mine turned off as I hate the feel of it and don't really seem to need it. I have heart block - ventrical. This is my third PM, and I've had the RR function turned off on all. When mine is on I feel it in my throat and find it very uncomfortable.

I suggest you talk to your doc and tech to see what they say. I was having an issue with it on my new PM and Frank and Don were the ones who told me what they thought was wrong. I had forgotten all about the effects I felt from the RR.

Try it !

by IAN MC - 2012-06-24 02:06:54

Hi Pete .. I guess the only way to find out is to have the Rate Responsiveness switched off and see what happens. It worked for me having it switched off but we all have different conditions. I think as long as your sinus node is functioning to some extent then you can try having RR switched off BUT I'm not sure what the implications are of having no AV node function in relation to RR.. your Drs will advise you.

I find it odd that that your pulse weakens after exertion, I would have expected an exaggerated response to exercise with RR switched on.The extra battery life is a minor consideration , it's how you feel that matters most.

Best of luck

Ian

Some thoughts

by ElectricFrank - 2012-06-25 12:06:11

With your constant afib the only way to handle it was to cut the AV path. This is intended to keep the fib from causing problems for the ventricles.

This leaves you with direct pacing of the ventricles as the only choice. You can either have the ventricle pacing set to a fixed rate, or to have the Rate Response use motion sensing to give an adapted rate. Your condition is what RR was designed to handle so I doubt turning it off would be a good idea.

My take is that there is either something wrong with the pacemaker setting or you have a heart problem that needs to be addressed. The best thing would be to either be tested on a treadmill, or wear a monitor. This should be able to catch what is happening during rest or exercise.

One thing that occurs to me is that the AV node ablation is not complete and that under some conditions like extended rest it may start allowing some of the afib to sneak through. This could cause some weird feelings. At the upper end your non functional atrium is likely not providing complete ventricle filling at the higher rates causing the weak pulse.

I'm only guessing at these, but they are a starting point for figuring it out. There is a tendency for docs to get out of dealing with such things as easy as possible. You may have to be a bit insistent.

frank

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