Pacemaker Memory Storage Question

pacemaker information storage

by new to pace.... - 2023-05-27 16:12:40

First it would help if you filled in your bio, as sometimes different locations will have different answers .

I have a medtronic carelink  bedside monitor which is different that an app.  

Mine stores and send nightly transmissions, do not notice anything.  Than i have a quartely transmission, again i do not notice anything.  Then  yearly I have an  in office download with the puck over the pacemaker.  Checks also to see if your wires are still ok and where they should be.

if you are away nightly the information is stored until your transmission.  It will say on the paper version missed transmission.  You can be away for at least a month.  Then you will need to take your monitor with you.  But do check with your pacemaker clinic for their advice as what to do.  

new to pace

Pacemaker storage

by AgentX86 - 2023-05-27 17:20:38

There is some memory but it is limited, mostly to totalling events, making histograms of some data. It won't store electrograms for a long period. Mine will only take a six-second electrogram and it won't save it. Your pacemaker has to be programmed, as instructed by your cardiologist or EP, to record what is of interest about you. It can't record everything.

I can assure you that it's not transmitting constantly. The bar that sweeps back and forth is only telling you that the app is still running. If it stops, you should get a text and/or email instructing you to restart it. When it transmits, it should send you an acknowledgement and it will be logged in the app so that you can verify that it was done.

Most only transmit monthly or quarterly to reduce the number of in-office visits. Some, like new to pace, check in every night but that's not the norm.

pacemaker memory

by Julros - 2023-05-28 16:28:17

Modern pacemakers record and store both the patient's electrial activity and how the device responds. When you go in for an in-person, routine device interrogation, they download that info and clear the memory. 

The provider predetermines what info they wish to be transmitted and how often it is to be sent. My Boston Scientic info is tranmitted every 90 days, and also uploads if I have burst of VT more than just a few beats, or if my ICD fires. If this happens, the office contacts me. 

Pacemaker

by AgentX86 - 2023-05-28 16:37:08

If your ICD fires, I don't think they're going to have to call and tell you. 😁

My pacemaker did call home once on its own.  Evidently, there was nothing there or at least nothing worth worrying about.

Good to know

by Gotrhythm - 2023-05-29 12:25:37

One of the things that keeps me coming back to TPC, whether I have a post or not, is that I learn things that are good to know, but I never thought to ask.

I am continuously grateful to those members who are more techno savvy who share their knowledge with the rest of us.

Pacemaker memory storage

by Theknotguy - 2023-05-30 11:54:19

Your question about pacemaker memory is a good question.  My short answer is the amount ofstorage and how it is stored on your pacemaker is probably proprietary to the manufacturer.

My EP was telling me the techs would review at the appointment (When we still had to go into see the techs.) and then erase the information after reading it.  But then I started having problems due to rate response settings not being adjusted correctly for my life style.

I ended up seeing a manufacturer rep who pulled up some screens I had never seen before.  We got into a discussion about when I was having problems and I was able to give him the date and the time, down to the hour I was having problems.  With the screen pulled up on the reader he was able to go back over a month and to the exact hour.  "I see what you're asking about.", he said.And I was able to see it on the screen too.  And this was after a tech reading and after they had "erased" the reading information.  

Based upon what I saw I'm guessing there is a lot more information being stored and being able to be retrieved than is being told to the general public.  Probably several reasons for that.1) Gathering information on pacemaker performance for research purposes. 2) Protection in case of a lawsuit against the pacemaker manufacturer. 3) Proprietary information to give them a marketing edge.  My pacemaker was eight years old at the time and I was surprised to see the amount of detail they were able to retrieve.

I'm on my second pacemaker and with the advances in technology since I got my first one in 2013, I can only imagine what is being stored on the pacemaker now.  The advances in RAM memory storage,miniaturization, storage compression algorithms, and battery usage are much further advanced so they can do a lot more with a lot less.  

My vehicle retrieves information from my cell phone and it talks to my home security system.  I jokingly tell people my next vehicle will probably be able to check my pacemaker to see if I'm fit to drive. People laugh but I sometimes wonder.  

lets think about it

by dwelch - 2023-05-31 23:28:29

Now yes the "take home boxes" as I call them have been around for a bit now, not a "long time" (I have had pacers for 35 years), but for a generation of pacers or two.  Before that it was generally a once a year visit.  My earily devices didnt even have some of the settings todays devices have much less any storage that I knew of.  The second or third I found fascinating because it did have some storage and reported things on the report (you should be asking for your copy of the report every time you go).  Working with processors and chips as a profession the tech gets smaller and more capable each generation.  So while the next device may have more features, better software, more automatic settings, more precise settings, more settings.  it may also be less power, smaller and have more spare storage.

The take home box is more of a revenue gathering solution for the industry than it is a thing for patients.  From this site we can tell that it has turned your home into a cage or a leash being afraid of going away from the box (my box is off other than a few specific days a year and that makes me happier than if it were on).  If you were part of the prior boxes with the magnet and how much that cost or how much of a revenue generation stream that was, this cant be any better.  it also greatly drives up the prices of the products with the insane cost of medical device development.  there is a wee bit of legal protection it gives the the device vendor more so than the doctor, and for some folks a wee bit more confidence in having the device, but I think it is more damage to the paitents confidence (afraid to go on vacation, leave the house, etc) than good, YMMV.

It is for the most part certaily corporate secrets as to some of these questions, on the other side of that though you have government/regulatory hoops you have to jump through and the big name folks have been caught with bugs and other things that could harm the patient, etc. So I thing someone gets to look over their shoulder if it isnt us.  

In general though I dont expect to get the kbytes or mbytes of flash or ram or other that stores this info (remember the device does not turn off and come back on so, they may not have to store it in flash like other devices you are used to.  I would not expect them to "erase" each time.  Instead have a "circular buffer" of events/info.  and makers to indicate the last time you dumped this was at this point, we are at that point I am going to move the marker.  Like moving a bookmark, you dont rip the pages out of the book as you read it or delete them from the e-reader, you just remember where you were the last time and go forward from there.   I would expect that if you went so long (year, two, four?) that the spare storage overflowed then there would be an indication at the next interrogation that there had been some information loss due to the duration.  I would expect that duration, esp with regulations, to be at least two years if not more before it runs out of storage.  And that is a game of okay size/cost/battery consumption, possible data we can collect, at what rate, etc. so they may collect less stuff or at a lower rate in order to meet some design requirement of X number of months of storage before running out of space.  You more importantly have speical events that are not periodically sampled, so there would be some estimate that the average person has this higher event people have that, so lets add X percent to that and have storage for Y months (my guess is minimum two years since one year visits is "normal").

I dont expect the take home boxes to dump and clear everything, I expect that that interface is looking for the bad events that warrant going in before the year is up.  Battery is close, the device has switched modes.  The patient is having this event often.  And then when you go in and get hooked up to the real machine it will dump and collect everything since the last time. or everything on the device.  (it could very well be as simple as the interrogation machine the operator looks at your chart, okay give me the last 11 months of stuff).

flash vs ram.  flash wears out, raise your hand if you still have some sub gigabyte thumb drives?  How many of them still work?  flash (non-volatile storage) wears out with erase and write cycles.  How many days are in 10 years?  15 years? 4000, 5000, that is not extreme to have a daily erase/write but for medical devices that is likely really bad, so it is not daily.  even if they were doing this storage on flash you would want to collect a certain amount in ram then periodically write a chunk of flash. but who knows.  I contemplated working for one of these companies but there is the engineering joke.   100 (name the type of engineer or programmer) get on a plane.  then you are told one of your coworkers did the (flight controls, flight software, name the item) 99 engineers get off the plane.   as much as you know about what is behind the curtain and could make that product yourself, you dont want to actually see how the did the one you are relying on, best to have faith and not work there.  I probably would have hooked myself up to something and accidentally done bad things and I wouldnt be here today, so also good I didnt go to work for one of these places (not that I cant still take one of those jobs if life leads me in that direction).

Every generation (say 10 years) the devices have notable new features.  They can store more detailed information, and ideally use less power.  My guess is they store much more than a year perhaps two plus years of information for a "normal" patient with "normal" volume of "events" and data.  I suspect they never actually erase, but instead have a marker and or the box in the doctors office is what is keeping track of "this is the last time I sampled and I only need the new stuff".  As reported by another comment, I would fully expect the right tech with the right machine to be able to gather much more information than the machine and software the docs office uses for periodic interrogations.  (could be same machine and software, just a different or special set of menus).  I futher assume that the upload over the take home box or phone app is not 100% of the information since the last upload but instead, kind of as you would expect this overall system solution to work, it is a report of events that would trigger a rapid response from the medical side to call you and get you into the doctors office or an ER.  Once there then the boring detail stuff can be collected if needed.  They dont care that when you saw a bug in the bathroom at 2 am three weeks ago and your heart rate jumped for 30 seconds if you could even exlpain the heart rate jump three weeks or three months or a year before, not relevant info when, no doubt, the quantity of information collected by these folks and then sold to the doctor at some fee, is in part, based on the number of bytes. (the folks that collect the data charge for that collection and delivery and nice big padding to cover any legal issues having that data)(the box at your doctors office does not work that way, it is paid for you feed it paper or a usb drive and that is its cost, unless the doc sends you to a rep then the rep charges the doc for every little thing and in the end you pay for that).  While the frequency is know or assumed to be the same as bluetooth which can deliver a lot of data (more than a modem, less than wifi), that radio is powered by your battery, every time you use it you take a chunk of power away from the lifespan of your pacer.  So the pacer side of this (vs the take home box side of this) is going to be very conservative as to how much it delivers over this interface.  this radio is a longer range, the one used to talk the thing they lay on your chest is different or can be than the one used for this take home box that is several feet away.   sigh. well so much for my bottom line summary, that turned into another rambling mess.

it stores much much much more than a few hours/days/weeks.  No reason to assume that it is erased from a take home box upload nor an interrogation.  Every generation of product and vendor to vendor details improve every generation of device, more storage, more stuff stored, and more features in the device.  Vendors have details that are internal and not for the public nor industry so some of these answers you might not even know if you worked there much less as a consumer or doctor.   Your doctor actually does not know much about the device either as far as these kinds of questions go, the tools they are provided are for day to day use not for rep or vendor use.   Revenue and legal protection I would argue are more relevant to the vendor in particular as well as the industry than the patience health and certainly mental well being, etc.  Many technical decisions are driven by legal or revenue or regulatory than golly gee this will make patients happy.  That also implies we did it this way because the government made our life suck so this is the game we are playing with them.  That sadly makes more design decisions than "this would help the doc with the patients treatment".   This question also touches on the touchy subject of collection, storage and distribution of patient data.

A year for mine

by PacedNRunning - 2023-06-01 12:16:37

Events stay stored for a year. They don't delete them. They can be overwritten if you have ALOT of events but before monitors the device stores  all the data just like it does today. Not everyone has a monitor. Once the data uploads via the monitor it's there for we long as they need it there. Nothing is wiped clean with home monitors. It doesn't have that ability. So if you had no contact for days. It's fine.