3 Month Check-up Results!

Short version -   Great check-up!  All systems functioning and no problems identified.  Settings adjusted to allow for exercise and my naturally lower nighttime heart rate.  Have my first echo next week along with lipids panel to see if any reverse remodeling has started and to see if my beta blocker holiday has had any benefit.  (more detailed version below)

Detailed Version:   Just had my 3 month post-implant check-up.  Great news all the way around.  PM functioning as it should.  I reviewed a long list of (previously transmitted) questions to my cardiologist who is awesome, and he went through them all with us.  The "events" noted on my upload were indeed all exercise related and of no concern. I specificially asked about the event tagged as "afib" and was told that this was reflective of a "catagorization" anomaly (the PM had to assign that rhythm it saw to 'something') and both the MD and the Devic RN agreed that i have had no afib events or indications of any arrhythmias of any type. *happy dance*  Same for "Active" vs "Rest".  Honestly, my cardiologist wasn't sure what the difference was supposed to be, but he wasn't fussed, so I won't be either.   They went ahead and lowered (turned off??? I don't remember his wording) my lower limit so my heart will be allowed to slow to its natural lower nightime rate of around 48.  As the MD said, my sinus node is in great shape so there is no need to pace it.  This should get rid of the ectopic beats I get at night. They also raised my upper tracking rate to 160 *insert another happy dance*, the cardiologist confirming my understanding that when my rate went above the previous limit of 130, the pm just stopped sending pacing cues to my left ventrical to contract rhythmically with the right ventrical- which is not what we wanted especially during exercise.  

However, there are a couple of points he reviewed that I'm not sure I was conscious of.  Nothing bad, but MD noted that while the Conductin System Pacing I had installed is excellent, there is still very little data to say if it has the same potential to facilitate the reverse remodeling of the left ventrical that we're aiming for.  Bottom line is that we won't know for a year if I will get this golden apple with my current system.  He said if I don't see the physical improvement in the left ventricle we can talk about replacing the current PM with the traditional CRT which has the body of data to show that I can get the "golden apple" ( reverse remodeling).  My cardiac anatomy didn't allow for the traditional 3-lead CRT to be installed the first time, but he said that now that we know the challenges, that additional maping and perhaps approaches can be taken that would allow successful placement. Hmmmmm.  Never really thought about that but I will admit that such a reality does exist.  In any case, it is nothing to worry about now.  I'll just have to focus on sending good vibes to my heart to do it's reverse remodeling with my current system as a way to add to the efficacy of the Conduction System Pacing approach.   And honestly, I'm not sure I'd go down this path a second time, but as this is all just one of several possible futures,  I'm not going to put the cart before the horse.  

I've my first post-implant echo next week along with blood draw to check my lipid panel.  Think 45-50% EF for me!  This is my initial goal.  Such improvement would support my preference to remain on a BB holiday.  Also think LDL <100 (or very close to 100) as this will support my choice of not wanting statins.  Improvement in both areas won't prove that the Hawthorn Extract I'm taking is the magic bullet, but good results will put a point in its column and make me a very, very, very happy person.  :)

8 Comments

3 month check up results

by new to pace.... - 2024-07-23 19:26:22

glad to hear all is functioning as it suppose to be.  Now you can relax until your next 3 month check up.

new to pace

Great

by Repero - 2024-07-23 19:41:15

 Yours is a happy story. There is only one aspect that I can comment on from very recent experience.

I have just had my upper tracking rate raised from 130 to 150. "Happy dance" indeed, because I have just been out Morris dancing and the change could not be more encouraging. No longer out of breath. Feel like I have got my youth back.

Recorded a maximum bpm of 142 this evening, which shows how much my previous limit had been holding me back.

I very much hope that you will have a similarly happy experience.

A good report so far

by Gemita - 2024-07-23 21:01:23

Andie, I suspect what is important now is how you feel, not your data.  Let us hope that you continue to feel well and are able to exercise to your full potential, that is what is really important going forward.  

Thank you for explaining about your events or shall we call them non events, particularly the questionable “Afib” episode.  Perhaps I read more into these things than is good for me, but I wouldn’t be completely satisfied with the answer you were given about there being a "categorisation" anomaly and the PM having to assign a rhythm it saw to ‘something’.  A comment like that hardly inspires confidence that the rest of the data is accurate or has been reported/recorded appropriately.  

To say that you had no arrhythmias of any type is questionable too.  Leaving aside the cause for your atrial high rate episodes which were all recorded as SVT/Sinus Tachycardia, your arrhythmia log reported many of these events and one episode of non sustained VT which didn’t seem to get a mention?  Of course these events are not dangerous, but they have been reported in your arrhythmia log as events and may need to be watched if you start getting symptoms when active.

I do hope too you won’t need a CRT upgrade in the future and that your current system will work successfully to improve your heart function but it is nice to know that there is a back up plan should you ever need it.  

Arrhythmias vs anomaly

by Rch - 2024-07-24 02:51:44

Agree with Gemita! What the Cardiologist implied was perhaps the events recorded were asymptomatic and thus clinically insignificant. If you have the detailed version of the data, you can look into the intracardiac electrograms and see it for yourself if it's truly A Fib, V. tach or SVT etc. Nonetheless, I am glad the events are all benign and asymptomatic ! 

 

Report

by piglet22 - 2024-07-24 07:50:31

One of these days I must ask for a full report. I can't say I'm optimistic.

I can look at the full notes and results etc. through the GP, but the hospital stuff is a closed door.

I'm experimenting lowering beta blockers slowly from 10-mg daily of Bisoprolol and now down to 5-mg, split 3.75-mg morning and 1.8-mg evening.

BP is a mystery to me, sometimes 140/80, this morning 110/60 all under the same conditions. And no sign of ectopics.

😃 yay

by Lavender - 2024-07-25 01:38:59

Short report says it all! Let us know what your new EF is!

Wish I had mine

by IrishToast - 2024-07-25 10:10:36

May I grouse again about remote checks? My 6 month "visit" (that's what it's down as) was June 15. On July 2 I got a chart notice of PM in situ. I called the clinic, they said Rhythm Management has the data and if that's all it says, all is good. I asked for the details and they promised to request them and the report would have to be mailed. I called the clinic yesterday, they said it was requested and mailed and I  should have gotten it already but they will put in another request. 

This outsourcing of our medical is not going well already.

Thanks to All

by Andiek11 - 2024-07-26 09:41:53

Glad I had a group of folks who "get it" with which to celebrate a positive milestone.  :)     (And sorry for those so frustrated at not getting the in-person care they deserve or who struggle to get any data.  Hang in there)  

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