Rate Response

I have read how several on this site have requested to have their rate response turned off on their PM. I am wondering, are your rate response settings primarily for increases or decreases in your bpm.

My rate response reacts to sudden drops in rate (25 in 25 sec. or less). The problem being, whenever I truly get relaxed, guess what happens! Then surprise I am at 100 bpm. I am wondering if I would benefit from having my EP look at whether or not this feature is truly needed.

3 Comments

Rate Drop

by peter - 2008-06-08 06:06:42

I am assuming you have a form of bradycardia. As your rate drops so low, your pacemaker is taking up the slack and giving you the boost of blood that you need to stay conscious. So my opinion is that everything is OK and that you have nothing to worry about. Cheers Peter

Rate response

by ElectricFrank - 2008-06-08 12:06:26

The rate drop response is only needed if you have episodes of light headedness or passing out caused by a sudden drop in HR.
The rate response that we have discussed often here is a different beast. It is used to provide pacing that responds to activity level if the hearts normal sinus pacing isn't working (often called sick sinus sindrome SSS). In this case if it is set up properly it can provide a good approximation of your natural pacing.
Where the problem occurs is if a person has good sinus pacing, but has an A/V block then they only need ventricular pacing controlled by the atrial beat. If atrial pacing and rate response is turned on there are now two sources of atrial pacing that can conflict with each other with uncomfortable results.
In your case I would ask the EP why rate drop response is turned on. Does he/she actually have any evidence that you need it. I understand what you are saying about relaxing. The docs rarely see a person who can relax deeply and quickly. I had a similar problem with my lower limit being set to high. If I just stretched out in the recliner my HR would quickly drop to the 70 lower limit and the pacer would kick in and hold it there. After a bit of a fight I got it set down to 55 and things are great.

Hope this helps. Drop me a note if you need more.

frank

Rate Drop vs. Rate Response

by shockbox340 - 2008-06-30 10:06:11

Frank's description is right on, but I would add that both settings can be adjusted. Meaning that if you really do need rate drop response for syncope prevention, they should be able to tweak it so that it doesn't send you racing at night. And with rate response, they frequently have to be adjusted to get them 'just right' and not overly or underly sensitive. IMHO, neither of these features should be on if you don't need them, so if dizzy/feinting has never been one of your problems it should probably be turned off.

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