Why would they add a third lead?

Hi! It has been almost four years since I have been to the club. My husband got a dual chamber pacemaker at that time and everyone here was SO helpful and kind to me when I had questions and concerns. He had a MAZE procedure after two failed ablations and ended up with a PM after the surgery, which is pretty common.

He has not had a single issue until they read his echo today. The cardiologist says (and I may have this mixed up) that he has an "abnormality" in the upper right chamber. They are doing a nuclear stress test on the 9th, but say he may need a third lead. but I really don't understand why. Has anyone had a lead added? What would be the reason? Can it wait? And, if he does have to do it, how difficult is it?

I feel that familiar queasiness with the thought of him having any more heart trouble as he just turned 47 and I'm frightened. This seems to be the only place I just say it. Thanks in advance for any thoughts, help or answers. I'm in a panic and maybe having more info will help and waiting until the 9th seems like a lifetime. Thanks!

2 Comments

Third lead

by golden_snitch - 2013-11-26 03:11:48

Hi!

If they are thinking about adding a third lead, the problem is not his right upper chamber, but the synchrony of his ventricles (left and right lower chamber). Because the right ventricle is stimulated, it pumps a little bit earlier than the left ventricle. That the ventricles are not pumping at the same time affects the output, especially of the left ventricle. You end up with some degree of heart failure. This complication is well known in patients who pace a lot in the right ventricle. Several studies have shown that patients, who need a lot of right ventricular pacing, have a much higher risk to develop heart failure and atrial fibrillation than those who are not paced in the ventricle.

Now, the third lead will stimulate the left ventricle and thereby put the ventricles back in sync. It is placed through the "coronary sinus", a vein which runs across the left ventricle. It will not be attached to the heart muscle inside the left ventricle, but will remain in the coronary sinus. The placement is a little more tricky than the two other leads. But since it's done more and more often there are many doctors who have much experience. The access, however, remains the same as for the other leads, there will not be another scar. The lead goes in through the same vein as the other two, and then just before it gets into the right upper chamber, it is directed into the coronary sinus vein.

Hope this helps.

Best

Inga

I agree again

by philip.thecyclist - 2013-11-26 05:11:49

Once more I agree with what Inga has said. I had a PM relacement in May for the very reason Inga describes. The effect of the third lead in my left ventricle was an immediate improvement and during excercise I experienced less breathlessness. If a LV lead to restore synchronicity is indeed the purpose of your husband's planned procedure then there he should benefit, at least over time.

Philip

You know you're wired when...

The meaning of personal computer is taken a step further.

Member Quotes

It is just over 10 years since a dual lead device was implanted for complete heart block. It has worked perfectly and I have traveled well near two million miles internationally since then.