understanding my biotronik pacemaker patient follow up report after implantation

by Dr. Casey Leannon 6 min read

Pacemaker - Biotronik

33 hours ago  · Initial Pacemaker Clinic Follow-Up Visit. An organized system of follow-up is important for all device patients and is best facilitated through the patient’s membership in a formal pacemaker/ICD follow-up clinic. The first formal clinic follow-up visit is usually scheduled at approximately 3 months after implantation to allow for completion of the lead-tissue maturation process, which may affect sensing and capture thresholds. >> Go To The Portal


At the 1 week appointment, the dressing from the incision will be removed and inspected to make sure it is healing well. In addition, the device will checked to make sure it is functioning appropriately. Another follow up visit will be made for a 3 month post - implantation check and then a follow up visit is recommended every 3 to 6 months.

Full Answer

How do I contact BIOTRONIK about my new pacemaker?

If you have questions about your new pacemaker, please contact the BIOTRONIK service team by email at patients@biotronik.com. We will answer within one business day.

Why is patient follow-up important for pacemaker/ICD patients?

An organized system of follow-up is important for all device patients and is best facilitated through the patient’s membership in a formal pacemaker/ICD follow-up clinic.

Do I need to reprogram my pacemaker's rate modulation?

In patients with pacemakers that have programmable rate modulation, you may need to reprogram the variable pertaining to this feature. Presently, the available sensors include activity and minute ventilation or combinations of these.

How does a pacemaker implant work?

Then, the physician will implant the pacemaker in the “pocket” beneath the skin at the incision site. He or she will then connect the leads to the device and program it to meet your medical needs. After a test to ensure the pacemaker is working correctly, the physician will close the incision with a few stitches.

What is a pacemaker follow up?

The frequency of pacemaker follow up varies from centre to centre. Follow up can be divided into three phases: early surveillance, maintenance period, and intensified monitoring period. In most cases a first follow up after discharge from hospital should be within four to six weeks (early surveillance).

How does a pacemaker send information?

Remote monitoring pacemakers and ICDs are equipped with a special transmitter. Using an integrated aerial, the implant automatically sends medical and technical information from your heart, to the clinicians who are treating you.

How is a pacemaker read?

Pacemaker codes It usually consists of three letters, but some systems use four or five: Letter 1: chamber that is paced (A = atria, V = ventricles, D = dual-chamber). Letter 2: chamber that is sensed (A = atria, V = ventricles, D = dual-chamber, 0 = none).

How often does a pacemaker transmit data?

Traditionally, with the wave of a wand, data from an implanted cardiac device is collected and downloaded during a routine office visit every three to six months, which provides your doctor with a history of the device's electrical activity.

What does a pacemaker report show?

The status of the pacemaker will be regularly checked or "interrogated" (often done remotely using a telephone or a secure web-based system) to provide information regarding the type of heart rhythm, the functioning of the pacemaker leads, the frequency of utilization of the pacemaker, the battery life, and the ...

Is there an app to monitor my pacemaker?

The MyCareLink app is available for free on Android and Apple platforms and works in tandem with a physician-prescribed portable device reader.

What is the normal heart rate for a person with a pacemaker?

The pacemaker will track or pace heart rates at the prespecified AV interval up to the upper rate limit. Upper rate limits are commonly 120 to 140 beats per minute.

What is the normal setting for a pacemaker?

Amplitudes are normally below 1.5 V and pulse duration (width) is usually set to 0.5 ms. Given that voltage (V) is constant and battery depletion must be minimized, most pacemakers use lead tips with high resistance (400 to 1200 Ω). The higher the resistance in the lead tip, the smaller the current used.

How do you interpret paced rhythms?

13:2516:42The ECG Course - Paced Rhythms - YouTubeYouTubeStart of suggested clipEnd of suggested clipPick the lead that has the biggest QRS complexes. And you know the easiest to identify p-waves. WhenMorePick the lead that has the biggest QRS complexes. And you know the easiest to identify p-waves. When you're trying to interpret those things don't use the hardest.

What does Biotronik do?

BIOTRONIK Home Monitoring is a system that allows your doctor to monitor your heart health and your implanted device remotely through daily data transmissions. These are sent, without you having to do anything, directly from your implant, through a transmitter (the CardioMessenger), and then to your doctor.

How do you know if your pacemaker battery is low?

Signs of Pacemaker FailureFainting or losing consciousness.Chess pain with weakness, dizziness, nausea, or vomiting.Trouble breathing.Heart palpitations (feeling of the heart beating fast, hard, or irregularly)Slower heart rate than usual.

What are symptoms of pacemaker failure?

Frequent or persistent palpitations (the sense that your heart is fluttering or beating fast or hard or irregularly) Slower than usual heart rate compared to your normal. Chest pain with weakness, dizziness, fainting, heavy sweating, nausea, or vomiting. Extreme drowsiness, confusion.

The human Heart

The circulatory system carries vital oxygen, water, and nutrients through our body. Our “engine” – the heart – keeps this system running

Health Conditions

For many of us, one day, our heart loses its rhythm. High blood pressure, cardiac arrhythmia or a heart attack are among the most common diseases we see nowadays.

Treatment Options

Heart disease is the leading cause of death in the United States. A wide range of medical therapies can treat various forms of heart disease and stabilize your health.

Procedures

Different systems are used to treat different types of heart disease. How do they work and what happens during and after treatment?

Daily Life

Curious about how treatment will affect your quality of life and what limitations you should expect? Read more here to find out how to get back to your daily life and what to watch out for in terms of diet, work, travel and exercise.

How long does it take to follow up on a pacemaker?

The first formal clinic follow-up visit is usually scheduled at approximately 3 months after implantation to allow for completion of the lead-tissue maturation process, which may affect sensing and capture thresholds. Reprogramming, to account for any threshold change since implant, and still provide a safety margin along with improved battery life, may be done at that time. Optimization of device function can be performed noninvasively. The patient generally will have additional questions at this time, and the pocket can be evaluated for appropriate healing.

Why does the second pacemaker spike not capture?

The second pacemaker spike does not capture because it falls within the patient’s refractory period.

Why is the lower rate limit of the pacemaker programmed to a value lower than the intrinsic rate before testing?

In VVI (or AAI) situations, the lower rate limit of the pacemaker is programmed to a value lower than the intrinsic rate before testing is begun because you want to be able to see the native activity. If the patient’s native ventricular rate is too low, the sensing threshold test cannot be carried out.

How does a pacemaker work?

On the back of the transmitter are two electrodes that are pressed firmly against the skin. These electrodes transmit an electrocardiogram, which is converted into sound waves and transmitted over the telephone mouthpiece to a receiver at the pacemaker clinic. The receiver then prints a rhythm strip.

What is transtelephonic monitoring?

Transtelephonic monitoring allows the pacemaker’s battery status to be monitored. Basically, the patient keeps in touch with the pacemaker clinic on a routine basis by transmitting a brief rhythm strip; the magnet is applied and then removed before the end of the transmission.

What are the symptoms of a pacemaker?

These include palpitations, dizziness, presyncope/syncope, or any symptom that may resemble those experienced preimplantation. The possibility of pacemaker syndrome always should be considered as a potential cause for recurrent or new symptoms. Complaints related to potential pacemaker infection also should be explored, including fever, chills, recurrent respiratory illness, or reports of swelling, drainage, or tenderness in the region of the pocket. Table 11-1 lists some symptoms that should lead to the suspicion of potential problems. Fortunately, most of these problems are quite rare.

What is HL7 compatibility?

Data can be printed out on paper, but a more common trend is to interact with electronic medical records and place data directly into the electronic record. This is a complex area, but a commonly used term is HL7 compatibility. This stands for Health Level 7 compatibility and involves a complex set of standards ( the vast majority of which are totally unrelated to the pacing industry) for integrating hospital data into physicians’ electronic medical records.

When was the first pacemaker implantation?

Since the first pacemaker (PM) implantation in 1958 , 1 guidelines have been developed and regularly updated to optimize chronic cardiac pacing. 2–4 These guidelines address the implantation procedure and the selection of the appropriate PM system, pacing settings and mode in relation to pacing indications, patient characteristics, and underlying cardiac disorder (s). The subsequent follow-up of the PM patient after implantation has received less attention, but is of similar importance in terms of patient benefits and safety of the pacing therapy.

Who is the follow pace study?

The FOLLOWPACE study is granted by the Dutch College of Health Care (CVZ/VAZ grant number 01236), all distributors and manufacturers of implantable cardiac arrhythmia devices in the Netherlands, The Netherlands Pacemaker Registry Foundation, Groningen, The Jacques H. de Jong Foundation , and The Roger Crowson Foundation for Human Arrhythmias Studies.

What information is collected during hospitalization for implantation?

During hospitalization for implantation, information on the patient's medical history, medication use, duration of the implantation procedure, personnel involved in the implantation procedure, performed measurements of the leads and PM, and changes made in PM mode and settings before hospital discharge was gathered. 12 , 13

When was the first study on recommendations for routine follow-up published?

After the first publication on recommendations for routine follow-up in 1977 by Furman, 5 only a small number of studies on this topic have been published. 2 , 6–11 These studies primarily focus on the requirements of the infrastructure of the pacemaker clinic and the training of the professionals in charge.

What is a follow up visit?

A follow-up visit was defined as an outpatient visit to the clinic where the PM was implanted and where the patient visited a cardiologist and/or an associated professional for a physical and/or PM check-up. Both, routine (pre-planned) visits and extra visits due to the occurrence of unexpected events, symptoms or any other reason, were considered in this analysis. Data on the time windows between consecutive visits, personnel involved at these visits, measurements on leads and pacemaker device, and changes in PM mode and settings were documented.

How long does it take to get used to a heart implant?

Many patients make adjustments to their lifestyle after receiving an implanted heart device. It will take time to get used to it. Most people take about four months to learn how to lead an active life with a heart device. It can be a challenge to accept the "foreign” device as part of your own body.

How long does a fever last after implantation?

Always consult your physician if you notice signs such as swelling, reddening or discharge from the implantation site, or if you have a fever that lasts longer than two or three days. Also ask your doctor if you feel dizzy or have chest pain, or if you notice that you are always tired.

Can you accept a pacemaker as a foreign device?

In the beginning, you may experience a loss of self-confidence, be very sensitive or feel blue. These feelings will subside over time as you emotionally accept the pacemaker or implanted defibrillator.

Before Surgery

Your physician will give you detailed instructions on how to prepare for the surgery. Usually, they will recommend patients stop taking blood thinners several days before surgery. If you take other medication regularly, ask your physician if you should continue taking the medication leading up to your procedure.

Implanting a Pacemaker

Implanting a pacemaker is a relatively simple surgery that lasts for two to four hours. You will receive antibiotics to reduce the risk of infection. The intervention is performed under local anesthesia, and sometimes sedation. It is not open-heart surgery.

After the Implantation

Usually, you will stay in the hospital for one or two days after the implantation. Listen carefully to and follow your physician’s instructions.

Listen to a Cardiologist

Dr Prasad explains what the recovery period after a pacemaker or ICD is like.

Listen to a Patient

Jeanette from Devon explains how she felt when she was given a Home Monitoring transmitter after her pacemaker implant.