Pacemaker self test

Consider this a public service announcement if you like.

I had my pacemaker checked today and got the opportunity to ask a lot of questions. One thing that came up when I mentioned the sensation of pacing (I have an intermittent AV block so only happens so often) was that the device is set to run a self test to find the lowest voltage that will trigger a heartbeat. It does this by starting at the highest setting of 5V and stepping down until there is no response.

Just as they disconnected the reader I got that sensation that I've described elsewhere, a few small twitches in the chest area in a row. Presumably when they disconnect, it resets and does it's thing but according to the technician, also once a day.

Add this to the list of things I wish I had been told beforehand!

8 Comments

I agree John

by Gemita - 2023-07-12 08:08:30

There are lots of moments like that when I wish I had known about something in advance.  I know many members report having sleep disturbed by automatic pacemaker checks or  downloads during the night or feeling symptoms from checks at specific times during the day.  Other fortunate members are not bothered by their symptoms at all, so I suppose our doctors/technicians won't make work for themselves and tell us about these things until they are asked or have to.   We could write a book couldn't we "On things we wish we had been told about our Pacemakers".

Well done you for asking all the right questions and I hope you came away with some helpful additional answers.  Thank you for sharing your experience.  That is the way we all learn

Write the book!

by John_Locke - 2023-07-12 08:18:30

I know they there are a lot of great historical posts here but maybe there could be something like a wiki with information like this, things you weren't told but should have been etc? I would have loved an honest FAQ like that ahead of the procedure!

Self test, etc.

by AgentX86 - 2023-07-12 12:21:40

I think the reason that we're not told a lot of things is that there is a tendency toward , to put it bluntly, psychosomatic symptoms. If the suggestion is made that there may be symptoms of ____, more will have these symptoms than otherwise would.

Of course, more may really have these symptoms but fail to report them because they will be thought to be hypochondriacs (and around the circle we go). I think they err on the side of "they'll let us know if they have symptoms of ____" and if they don't tell us, ____ must not bother them much.

In this particular case, my EP didn't turn it on because, in his experience,  the feature caused more problems than it solved. Setting a resonable capture margin was enough.

Another reason for not telling

by Gotrhythm - 2023-07-12 14:21:49

Copnstructing a one size fits all FAQ would be impossible.

There is a huge variability in how sensitve people are to sensations coming from the heart. And  among those who are sensitive, there is  large variability in how they react to the sensations. Finally, there is no way of predicting which patients will have which reactions and wonder, or be distressed, by them. 

I remember once when I was walking very fast down the hall to test the effectiveness of a settings change I remarked that I could feel my heart beating hard, but that wasn't a problem. It seemed appropriate to walking fast. The tech sort of chuckled and shook her head, "Yes, I know. I've never understood why some people think it's scary to feel their heart beating. You'd think they would be reassured."

Ventricular automatic threshold test

by Rch - 2023-07-12 16:13:01

In my Boston Scientific Accolade, it is performed every 21 hrs! I had one this morning at 7.16 am. I can expect the next one tomorrow 4.16 am. Fortunately, I can sleep through it!! I hate it when it happens on the bay bridge!!!

PM Self Test

by WazzA - 2023-07-12 19:09:29

I have an ABBOTT Assurity which self tests every 8 hours I know what time of day it is when I'm resting & feel it. If I am active I may not notice it at all! Those small shocks are definitely noticeable  even though they are NOT painful they seem to be very similar to ectopic beats ie pac's & pvc's. 

IT would be nice

by PacedNRunning - 2023-07-13 02:05:41

Yes! It would be nice if they told us about these daily tests.  I remember the first week I had a device, I imagined someone playing with a computer and fiddling with my heart as I felt the test. Awful! I had them turn it off.  I think they belive we won't feel pacing or the testing. Believe it or not, most do not feel pacing. But they should mention it to everyone so we have heads up this is what is happening. 

 

what they tell us

by Tracey_E - 2023-07-13 09:20:21

A lot of people don't understand or want to understand their device and condition. I've found that if I ask questions and make it clear I want to know, they are very forthcoming with information. 

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