Well, I had my 3-month post-op (much delayed due to doc's schedule) pacemaker interrogation and consult with my electrophysiologist. The pacemaker is in fine shape - leads are solid and present good connectivity, very little skin irritation from things rubbing on it, etc. Atrial pacing takes place about 60% of the time and ventricular close to 100%. No real change there. The high percentage of ventricular pacing is because I have some A-V node disturbance and the time delay between my atrial and ventricular pulses is too long, thus the pacer triggers my ventricle. So it has been, so it is.
That's the OK news. Now the interesting stuff - I do still have some underlying natural ventricular pacing taking place, but it is not yet strong enough to rely upon. This is an apparent improvement over the last check-up when I showed no native pacing. Time will tell whether or not this pacing will grow strong enough to dial down the pacer involvement. We've decided to wait and see.
And now the really interesting stuff - for me, anyway. After having a "life-style" discussion update with my electrophysiologist, he agreed to change some of my pacer parameters. Initially upon implantation my pacer was programmed to allow a range of heart rates from 60 to 130 BPM. I had tried to get them to increase the upper limit last visit, but they held fast, wanting to give my heart more time to heal. This time, after hearing the report of my progress to-date at rehab, they agreed to increase my upper limit to 150 BPM. This should give me some extra capacity for jogging and other higher intensity cardio activity. They also turned on another "rate response" function. Initially they had enabled only the vibration/motion sensor, which increased my heart rate when it sensed my body bouncing - as in running outdoors or walking. This did nothing for exercises that didn't bounce me up and down, and even walking on a treadmill was less than thrilling, as it cushioned the bounce. So, we turned on the respiratory rate response function, which will raise my heart rate when it senses my breathing rate increasing due to exertion. That will be interesting to try out this afternoon at rehab.
Now for the really great news. NO MORE AFIB! I have been taking warfarin since surgery due to a bout of afib post-op. According to my pacer logs, my last incident of afib was on March 27, so the EP agrees that the afib was most likely a common case of post-op afib, not chronic. With this major observation he agreed that I can now safely discontinue the warfarin! One more pill bites the dust! Now I just rattle a little bit from all the pills I gulp down daily.
All in all, I'd call it a really good outcome. Now to see how this baby runs now that we've done a tune-up and advanced the timing a bit. . .
That's the OK news. Now the interesting stuff - I do still have some underlying natural ventricular pacing taking place, but it is not yet strong enough to rely upon. This is an apparent improvement over the last check-up when I showed no native pacing. Time will tell whether or not this pacing will grow strong enough to dial down the pacer involvement. We've decided to wait and see.
And now the really interesting stuff - for me, anyway. After having a "life-style" discussion update with my electrophysiologist, he agreed to change some of my pacer parameters. Initially upon implantation my pacer was programmed to allow a range of heart rates from 60 to 130 BPM. I had tried to get them to increase the upper limit last visit, but they held fast, wanting to give my heart more time to heal. This time, after hearing the report of my progress to-date at rehab, they agreed to increase my upper limit to 150 BPM. This should give me some extra capacity for jogging and other higher intensity cardio activity. They also turned on another "rate response" function. Initially they had enabled only the vibration/motion sensor, which increased my heart rate when it sensed my body bouncing - as in running outdoors or walking. This did nothing for exercises that didn't bounce me up and down, and even walking on a treadmill was less than thrilling, as it cushioned the bounce. So, we turned on the respiratory rate response function, which will raise my heart rate when it senses my breathing rate increasing due to exertion. That will be interesting to try out this afternoon at rehab.
Now for the really great news. NO MORE AFIB! I have been taking warfarin since surgery due to a bout of afib post-op. According to my pacer logs, my last incident of afib was on March 27, so the EP agrees that the afib was most likely a common case of post-op afib, not chronic. With this major observation he agreed that I can now safely discontinue the warfarin! One more pill bites the dust! Now I just rattle a little bit from all the pills I gulp down daily.
All in all, I'd call it a really good outcome. Now to see how this baby runs now that we've done a tune-up and advanced the timing a bit. . .
