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Atrial Amplitude/Capture Management problem conclusion - Will be fixed tomorrow
- by Good Dog
- 2024-04-29 13:01:23
- Batteries & Leads
- 444 views
- 9 comments
Just a quick follow-up on my problem. I spoke with the Nurse Supervisor in the PM Clinic at the CC this morning. Given it was a Monday morning and she was obviously very busy, I did not think it appropriate to take a lot of her time trying to get better educated on the Atrial Capture Management feature at her expense. Besides, I found a great explanation that helped on the Medtronic website (see note at the end with the URL). However, I did explain the problem and why it concerned me so much. I also went through my history with the sensing issues on my old lead and the fact that it had always been adjusted manually. Also, I spent a little more time studying last night and discovered that the aplitude on the lead that is auto-adjusted from that feature with a setting of "adaptive"; was the absolute maximum available of 5.0 volts. I told her that is exactly the amplitude my lead is applying since it was turned-on and that it is draining the battery unnecessarily. I have almost never required more than 2.5V in the past to achieve caputure when adjusted manually. I also told her that this feature had never been utilized in the past and I feel that there is no reasion it should be now. She agreed and offered-up an appointment for me to come in tomorrow afternoon to have it turned-off and the capture manually adjusted. I was thrilled with her response and really happy that I will now be able to put this issue behind me. My stress-level has now returned to a manageable place.
Btw: My new generator is exactly the same as my previous one. I think primarily, because it may be the only one that my old lead will adapt to. Though the point I want to make is; that as long as nothing else changes, I should get the same longevity as the previous generator (9 years). We'll see!
Once again, I want to thank everyone from this club for all their help and support. I am very grateful. If you take-away anything from all of this; we should not take anything for-granted. It would be nice if we could, but we should not.
NOTE: Here is a great resource (Medtronic Academy) I discovered yesterday that may be helpful to better understand the Atrial Capture Management feature. There are also others that you can find there too:
https://www.medtronicacademy.com/en-us/content/atrial-capture-management-feature
Sincerely,
Dave
9 Comments
Thank you Gemita
by Good Dog - 2024-04-29 14:37:14
This has not at all been a waste of time. It has been a learning experience for me. In the past I had not taken much interest in learning the techinical aspects of my PM and the programming beyond just the very basics. I just never felt the need. The little bit that I have learned here was only by necessity. Like most of the sentiments others have expressed here; we should not have to be that well versed in all of that. It shouldn't be necessary nor should it be our responsibility! Of course, this experience has caused me to re-think some of that.
I see this experience no differently than if I took my car in for a tune-up and immediately after it was returned to me, it began to stall-out frequently and the gas milage was cut in-half. I think it is a very reasonable assumption that the problem is "almost certainly" the result of something that was done during the tune-up. I do not have to know all of the technical details related to the cause of the problem. Although it may be helpful to expedite the remedy for it. Really, I just need to be able to explain the symptoms. That was the case here. I did learn a little and put some extra effort in it that I think helped to expedite the fix. However, there is no doubt in my mind that the Pacer Tech's have forgotten more than I will ever know. That is the way it should be.
And you are right about it helping to discuss these things. Also, this being the very essence of what the Pacemaker Club is all about. Listening to and learning from others here has been extremely rewarding for me.
Sincerely,
Dave
Good work, Dave
by Lavender - 2024-04-29 22:29:36
Your research will help others on the path behind you one day. Let us know how things go. I am impressed with how quickly they are getting you in!๐
Glad They Listened to You
by SeenBetterDays - 2024-04-30 06:01:34
I'm so pleased you got a favourable response from your team. It's refreshing when you have someone who is willing to listen to you and act on that information. After all that research and worry it must be a blessed relief. I hope you get the settings changed and your battery longevity reflects that. Thank you also for sharing this with us as I certainly learnt some new and useful information from your posts. Good luck Dave and let us know how it goes with the adjustments.
I am feeling great!
by Good Dog - 2024-04-30 20:13:19
The Atrial Capture Management feature has been turned-off (this afternoon) and atrial capture was adjusted manually without any problem. The atrial lead amplitude dropped from 5 volts to 2.5 volts and I feel great! So I am really happy to have extended my battery life significantly!
So thanks again to everyone for their support!
Sincerely,
Dave
๐๐ผ๐๐ผ๐ฅณ
by Lavender - 2024-04-30 22:01:00
I'm so proud of you and everyone who helped you get to this moment! How relieved you must feel!
I am more than relieved
by Good Dog - 2024-05-01 09:19:18
I am ecstatic!
On the way home I was reflecting on the experience of the reprogramming and it put a big smile on my face. As the Tech was making the changes he turned to me and said; "I have it set now with an amplitude of 2.5V and we have capture, but I think we should include a 0.25V safety margin". "Are you O.K. with that?"
I was smiling, because as I reflected back on it I thought; in what world would a Pacer Tech ever ask me to approve the atrial capture settings? Now that is progress!!!
Dave
Progress indeed
by Gemita - 2024-05-01 09:59:29
Dave, that is progress and deep respect for a patient who has worked incredibly hard to understand his settings. A settings safety margin of 0.25V above the 2.5V is no where near 5.0V, so we are still in a much better position as far as battery preservation goes. Doesn't it feel good to be in control or at least "an equal partner" in your own care?
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When the patient knows best?
by Gemita - 2024-04-29 13:37:04
Dave, I know the Medtronic Academy well. An immensely helpful site.
None of this has been a waste of time, has it? It just shows us how much research has to go into asking a simple question about one of our settings to be able to get a satisfactory answer. Actually a satisfactory result, but we have to be sure that what we are asking for will actually solve the problem and not make matters worse. That is why my technician probably tells me to leave these technical details to them. However I do not agree with this either. It is my device, my heart and I know what is best for me - some of the time! For example like you, I have now had Rate Response turned off and I hope it stays off, since my rhythm disturbances are much quieter now. A great improvement.
We get ourselves so worked up about these matters and then we find a busy understanding Nurse Supervisor more than willing to do what we asked. Well done you for doing your homework and putting your case across with such confidence. It so helps to discuss these things too, doesn’t it. I do this a lot here. I also send messages/questions to my pacemaker clinic and always receive helpful messages back.
I may ask about my capture management adaptive setting since I am 100 % paced in the right atrium. What a thoroughly technical, challenging post you created Dave. Keep them coming. This is the very essence of what the Pacemaker Club is all about.