New try! Piezo crystals can do many things, depending on how they are mechanically connected to the devices. Since the accelerometer is so tiny, it does not take much to excite it, unlike the accelerometers in inertial navigation systems in planes & missiles. ![]() Every little vibration of the body is now passed on to the accelerometer in the PM & sensed - hence the lack of differentiation between walking & jogging. Essentially, it is now held to the body like it was nailed to a wooden post. Now go to your sub-pectoral implant - I'd hazard a guess that now the PM is considerably more constrained by the mass of muscle over it & a tighter fit in a less elastic pocket. kinda like it is connected to the body on a spring w/ a damping device also connected to it. (IIRC, the symbol for Berlin is a bear, isn't it? So there's a connection to my black bear post) When placed S-C, the PM can wiggle around in its pocket a bit, hence the mechanical coupling between the body & the PM is somewhat reduced. Let me give the world something to think about on this problem. BUT, if the placement really affects the rate response sensor, I'd have to think it over again. Had it under the skin twice, and always ended up in pain. There has been some talk about replacing this pacer with a different model that offers more (manually programmable) options regarding rate response. But then, pressures shouldn't play a role, this is an accelerometer based rate response (minute ventilation had to be switched off, doesn't work with epicardial leads). He said the pressures on the pacemaker unit are different when it's placed subpectorally. ![]() He doesn't implant pacemakers this way, he always implants them on the right side subcutanaeously. Now, the last two times I saw my cardio, he mentioned that the subpectoral placement could have an affect on the rate response sensor. It responds very aggressively, so whenever I just walk to the subway or the supermarket etc., I get 130-150bpm. Basically, it doesn't differentiate for instance between walking and jogging. I have been dealing with rate response issues for quite a while to the point where even the manufacturer doesn't know what to do. I have a quick question for those of you who have their rate response turned on AND have their pacemaker placed subpectorally (under the muscle): Have you ever been told that this placement could somehow affect the rate response sensor?
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