Out of Practice

Hello friends, it has been a while since I've seen a print-out of my PM interrogation. Usually, the techs erase the info when they do stuff during my surgeries. Today, I came home with my first copy in 2+ years for my Medtronic dual-chamber Enpulse. There was a new tech and she was sweet but not forthcoming with explanations like I remember having in the past. In a five month period, I've had over 58,000 PVC singles, 5,000 PvC runs, and 9 PAC runs. I had 17 ventricular high rate episodes, the fastest was 208 (V) - I guess for ventricular???, and the longest time was over a minute. Is that too short to be classified as fibrulation? I asked for this check because I've been dizzy a lot, sometimes waking up feeling a tightness and especially for some postural hypotension (getting up too fast, I guess). I got my PM 5 years ago for bradycardia due to unusual, if not rare, heart block at the HIS bundle, probably due to scarring from inflammation that was the result of my autoimmunine disease (ankylosing spondylosis). I'm pacing about 39% of the time. Two years ago, it was only about 19%. Before the PM, I'd have syncope, and fall like a fly - once on the Tom Thumb store's floor - splatt ! LOL. Any novice interpretation help would be appreciated. Thanks so much.

3 Comments

Readings

by ElectricFrank - 2010-05-07 11:05:58

The PVC's figure out to about 380/day. That's not bad at all. I've been as high as 2500/day which while a bit uncomfortable wasn't a problem.

Check the mode setting. With any sort of block, but normal sinus rhythm the usual mode is DDD. If it is DDDR or any of the modes with an R it means Rate Response is turned on.This can cause a number of strange problems. It caused my some problems right after implant and I had a bit of a fight with them over my settings. Once I had the mode changed to DDD and my upper tracking limit increased from 120 to 150 I was raring to go.

You mention dizzyness. Are you having vertigo or pre-syncope. You probably know the difference, but just in case vertigo is an inner ear disturbance that give a sense of the world spinning. Syncope is where things get sparkly and go dim. I mention this because even doctors often don't know the difference. If it is vertigo it has nothing to do with the pacer or heart.

frank

PVC's

by thomast - 2010-05-08 11:05:54

Boy you'al have differant doctors than I do. I had about 5000 once over a period of a year and my doc had a fit. Doubled my dose of coreg, now have about 10 or so over a 3 month period.

Thomas

Different docs

by ElectricFrank - 2010-05-09 02:05:24

There is a debate going on in the cardiology field about the significance of PVC's. For the ones that are concerned about them the issue seems to that they could trigger a more serious arrhythmia. On the other side they point out that almost everyone has runs of them. There is also some research that shows a higher death rate in patients given drugs for PVC's.

Then there is the drug companies that see another gold mine. Any condition that affects very large groups of people and can be marketed using fear!!!

I also saw one article that mentioned that PVC's that occurred or increased during low HR were generally benign. The risky type increased as the HR increased.

And finally, it is easy for the cardiologist to misread the pacemaker PVC report. With the Medtronic pacers the PVC counter is only reset during an office interrogation, but not with a Care Link phone checkup. So the doc takes a look at the report after a couple of phone checks in a row and thinks that is the number since the last phone check.

confusing, huh?

frank

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Muggers want your ICD, not your wallet.

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