Pacemaker Check questions

[quanglewangle]

Hi

My most recent pacemaker check was done remotely and I heard nothing (just a letter telling me it was about to happen).

I asked my GP surgery for a copy of the report and of course it is mainly gibberish to the layman.

A couple of things stood out; What does an Atrial Burden of 96% indicate? And what does Status YELLOW indicate?

NB it also says "Follow-up recommended" but I have heard nothing .... How long should I wait before querying this - and who do I chase - GP, Consultant, or Clinical Physiology?

[BobD Volunteer]

I am no expert but I would guess that atrial burden 96 % means that you are in AF 96% of the time. In normal life yellow would be a lower state than red but still need looking into.

[CDreamer]

My pacemaker is read remotely and I think you did really well to get a copy of the report because that’s more than either myself or OH have ever managed! And I think the reason is because it will be mostly gibberish to layman.

If I want information I ring the Pacemaker clinic at my consultant’s hospital which is run by the Physiologists and is usually Dept of Clinical Measurements as they are the people that read the reports and send to the doctors.

Follow up could just mean a trip to the pacing clinic to have the ‘magic circle’ placed over the pacemaker so they can check what the PM is doing. If there were an issue of concern I am sure they would have you in very quickly

If you are worried about I would suggest you ring your clinic sooner than later and ask to speak with a physiologist, they are usually really helpful.

I think, not sure, the Atrial burden is the amount of time you are in AF. The only figure I ever want to know is how much is the PM is pacing ventricles and for me it’s about 98% of the time.

[baba in reply to CDreamer]

I don't get a copy of the report either, which I'm not happy about.

[goldey in reply to CDreamer]

Hi --- I was told that the percentage of time the pacemaker is working is not the amount of time that I am in AFIB -- I was told that the percentage of time it is working is when my heart rate drops below 50 bpm. When it drops below 50, the pacemaker gives my heart a little boop, and it start going up again. I am almost never in AFIB, but my last test showed that my PM was working 28% the time. That means that 28% of the time my heart couldn't carry the load and fell below 50 pbm. And had to give me a boop to make sure it didn't fall any lower. 3 years ago I had 4 cardiac arrests, that is when the heart stops beating altogether. My wonderful pacemaker ensures that that will never happen again, because it stops it from falling below 50.

[CDreamer in reply to goldey]

I agree - the amount of time the PM kicks in is nothing to do with time in AF - all the PM does is measure the time in AF. Depends on the person & the PM as to the reason for implant. Originally mine was implanted prior to AV node ablation which would have left me 100% reliant upon PM. Mine resyncs the ventricles primarily. Mine kicks in as soon as my HR dips belie 60.

Mine was not implanted for Bradycardia.

[Hidden]

Hi quanglewangle (lovely name 😊👍), I'm sure you know already that a pacemaker doesn't change your atrial fibrillation but controls a slow heart rate. Therefore atrial burden in this setting will be describing the duration of the longest AF episode you had while being monitored. I'm not exactly sure of the meaning of the 'yellow' finding, but I do know that there is a system of yellow and red alerts, and I would think work like cards in a soccer match with a yellow finding meaning that there was a lesser problem found which may need attention, whereas red would indicate a bigger problem needing more urgent attention. I do think though that you should check with your surgery for some help with reading your report. You can then ask how long is reasonable to wait for follow-up. Hope this helps!

[CDreamer in reply to Hidden]

Actually depends upon the PM, the settings and the person as whether or not the PM can control AF - my re-synchronisation therapy does control the AF and my EP has a few patients for whom it does but doesn’t work for everyone. My AF burden was less than 1% last year - purely because of the PM as I take no meds.

[baba]

I think you should contact the pacemaker clinic, Clinical Physiology.

Ask them to explain the report and who the follow up is with. Who is arranging it?

I would also ask your GP the same questions.

[TracyAdmin Partner]

If you are concerned about the report, and to put your mind at rest, please contact the clinic or your doctor \ arrhythmia nurse to explain whether any further action is required at the moment.

[Clarrie]

I had a letter from the hospital saying they had carried out a remote transmission in July when I had had my pacemaker for 12 months and that it was within acceptable levels. It gave me the date of the next check in June 2022 and said to make sure the monitor was connected at that time.

[CDreamer in reply to Clarrie]

I have 2 checks a year - 1 remotely & 1 when I visit the clinic & have the magic circle & everything is checked - weird feeling when they purposely change the rate.

The move seems to be more toward remote monitoring. The only downside is having to keep my phone within a few metres & the app open.

[Clarrie in reply to CDreamer]

Thanks for your reply CDreamer. I have a monitor by the side of my bed. I have an appointment booked for the pacemaker clinic in December.

[JudyMarieC]

I have a remote transmission every 3 months. The only information I get is an email telling me that the transmission was successful and another email telling me when the next transmission is scheduled. When I asked one time for a copy of the report, I was told that it was pages long but my EPs office sent me a one sentence statement saying that the pacemaker was working efficiently. The only time I can get detailed information including my afib burden is when I'm at the office and the pacemaker is interrogated. It's very frustrating not to have the information you'd like to have.

[Evefay]

I send a transmission every 3 months and they check it in the office every 6 months. I am not dependent on my pacemaker but it is set at 75 bpm because the meds I take cause it to drop too low. I know when I'm in afib so I usually tell them to check those times and make sure it was afib as I also have svt, pvcs and bigiminy. They will tell you anything you want to know.