PM motion detector in 1 year old

Our son is about to have his motion detector turned on in his PM next week. Currently he has CHD which required pacemaker implant at 10 mos of age after two open heart surgeries at 4 days and at 4 mos of age. Over the past month he has not been very active when awake and we think that it is because his active heart rate has been between 80 - 100 bpm. His current PM is set to respond at 80 because he went bradycardic when he slept.

Is there anything that we should be aware of from the motion detector and him having a suddenly fast heart rate? Don't have a clue what to expect from the doctor / nurses or from our son. Any advice would be great.

Thanks

4 Comments

PM Motion Detector/Rate Response

by SMITTY - 2008-04-05 11:04:52

Hello Kringo,

If what you are calling a motion detector is the same as what my doctor calls a rate response feature on my pacemaker I can tell you what I know from my experience.

First your son should not be any more aware of the rate response being activated than he is with the current activated features on his pacemaker. My rate response monitors my heart and senses my physical activity. When my physical activity increases my pacemaker will interpret that to mean there is a need for an increased heart rat and it speeds up my heart rate. However, if I understand how this thing works, when my physical activity increases the rate response hesitates for a few tenths of a second to be sure it is a continuous activity before increasing my heart rate.

Most of the time turning on this feature and getting the best setting for a particular person is a one time thing. However, for some of us it takes several trial and error settings to get the best setting. I would suggest that you speak to his doctor about the things to watch for to determine if there is a need for a change in the settings.

If I have to pick out two things that created problems for me it was the timing on mine and it was too quick to say I needed an increase in heart rate. (Let me point out here, I’ll be 79 next month and what transpires with me may not even be a consideration for your son) Like if I was traveling over a rough terrain such as a very rough road my rate response would interpret that as my increasing my activity and crank up my heart rate. It turned out that all that needed to be done was decrease the sensitivity setting to solve the problem. Another little problem that was more difficult to solve was to get the timing setting right. In an attempt be sure my heart was pumping an optimum amount of blood my pacemaker would get over anxious (my words, not my doctors) and have the ventricle contracting before the atrium had completed its job. This caused a slight pressure increase on the valve between the atrium and ventricle which I felt as slight pain. Ordinarily the amount of pain would have been almost unnoticeable, but any pain around my heart always gets my attention. It took three or four tries to get the timing right and stop me from feeling any pain.

Other than those two things I am never aware that I have the rate response feature activated.

I wish your son the best.

Smitty

NOTHING TO WORRY ABOUT

by peter - 2008-04-06 02:04:16

Turning on the motion detector after pacemaker implantation is standard practice. Mine was turned on 7 days after implantation. I did not notice any problems or changes at all. It will be ok dont worry. Cheers Peter

Brand New

by Crystyna - 2008-04-06 12:04:33

Hello! Just wanted to tell you I'm sorry you have that experience. I'm a nurse and hated to see you write you had no idea what to expect ... though even as a nurse I've had the same experiences with health care members outside of my hospital - thus I came here...
I only know my pacemaker,- only a month old has the rate response feature activated... and the printout says 30 seconds after Activity Acceleration...
Sorry I couldn't be of more help, and so very sorry your son has to go through this...
Christina

Similarly situated

by slarnerd - 2008-04-07 01:04:22

Hi! My son is 20 months old and got his pacer at 2 days old due to complete congenital av block caused by neonatal lupus. His pacemaker is normally dual-chamber, rate responsive to his atrial rate but his atrial lead broke in October when he was 15 months old. SO. They left his ventrical rate at 80 but set it to be responsive to motion, as you describe. Before his lead broke, he was also between 80-160 or so. He started sleeping excessively (18+ hours a day), not eating well, and looked ashen and bluish. We returned to the EP's office and they turned his setting from 80 to 110, still responsive to motion. What a difference! He turned pink before our eyes! And his appetite, activity level improved dramatically. He obviously needed more cardiac output to function normally (for him). However, I know of paced kids about his age that have settings as low as 65 w/ motion setting and do fine with that. It is very individualized and sometimes the nuances are not as easy to see with a pre-verbal child. That said, as a previous poster said - they can always change the setting if it isn't working well for him.

Regarding the motion setting on a toddler -- it doesn't really work like it does in an adult, nor do they follow the same settings, I don't think. This is b/c an adult (or older child, teen, etc) does a prolonged activity and not only raises their heartrate but also maintains it if doing aerobic activity. A toddler is plenty active but their normal HR does not fluctuate very dramatically b/c they have such a short attention span and do almost nothing for more than a few seconds, minutes. :)

I hope that helps and I hope his new setting helps! feel free to send me a PM and you are also welcome to join the yahoo group for parents of paced kids.
http://health.groups.yahoo.com/group/heartblockkids/

Sterling

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