Leads(new member)

Hi All,

I am new to the site and wish I would have found you all sooner! I am 33 and had my first pacemaker in when I was 19. When I was 27, I had a new generator put in and they extracted one lead with a laser. My battery just went in to low voltage mode so I will be setting up the generator replacement within the next few weeks. My questions are this:

The tech indicated that he was not able to get a good read on if the leads were fully functioning and the only way they would truily know for sure is when they tested when in the process of changing the generator. does this sound right to you? I ask because the other lead that has not been replaced yet is 14 years old now and from what i understand, 14 years is a while and it is very possible that it is nearing the end of its life. The last thing i want to do is to have the generator replaced, only to have the lead go bad on me shortly thereafter and have to go back under the knife. I am considering the thought of asking them to just replce that lead while they are in there already. Is that a bad thought to have?

Last but not least, any mustard procedure patients out there?

9 Comments

Leads

by ElectricFrank - 2010-10-21 01:10:48

The techs information that he can't determine the leads condition until the surgery is correct. Especially with leads as old as yours it is better if he tests them with an external instrument.

As far as whether they need replacement there doesn't seem to be any rule on how long they last. There are a couple of failures that can happen with the leads. The most common happens soon after installation where they come out of the heart wall. Once you get past this time period they seem to be pretty reliable. The other failure modes happen with time. One is where the constant flexing of the leads causes break or short circuit. Another is when the location on the heart where they are inserted loses its sensitivity to pacing either from scarring or constant current pulses.

My feeling is to keep the existing ones unless they show signs of failing. For me the replacement surgery is so easy that it wouldn't be a concern for me. I had mine replaced in Jan as outpatient and chose to have it done with only a local anesthesia. I left the hospital at around 5:00PM and stopped for dinner with a friend on the way home. Having the lead replaced would make the whole thing a lot more involved with having the arm lifting restrictions etc.

There are several here on the site that have had leads for a good many years. Maybe they can jump in with their experience.

good luck,

frank

Great Feedback!

by paceguy - 2010-10-21 02:10:16

Everyone,
Such fantastic Feedback, thank you all, I am not surprised at the indepth responses i am getting.. Tracey, the reason you state is what i have been thinking of today and ultimatley is what is going to make me not make any rush decisons on replacing the lead when it is not needed. "If it ain't broke, don't fix it!", and when it does need fixing, hoepfully the fixes have improved gadgets to eliminate the risk.

thanks again everyone, have wonderful day!

more on leads

by mclark - 2010-10-21 02:10:43

my original lead is still in place and working fine. 27 years. My 2nd lead is about 14 years old.

Matt

Mine lasted

by Beckes76 - 2010-10-21 03:10:06

My original leads (both of them) lasted 21 years. With my last battery change I had them move my PM. Because they moved my PM I had to get rewired. The two surgeries that I had both times they checked to see if it was the leads or not and both times they were okay. This last one I don't know if it was the lead or not. Hope this helps a little bit.

Becky

compromising situations

by Tracey_E - 2010-10-21 09:10:16

The way I look at it, technology gets better every year. The sheaths they use to extract get better and better, the number of drs experienced with it gets higher every year, leads get smaller and more flexible. That's why I don't see it as putting myself in a compromising situation later, I see it as lowering my risk by waiting. Let technology move ahead as long as what I have now is working.

Hi

by Gellia3 - 2010-10-21 09:10:18

I have had my original dual chamber leads since early 1982, nearly 29 years now.

I sure plan on keeping them as long as they function well and so far, so good.

As long as they stay patent, they are OK. My EP has told me he wouldn't fool with mine at all unless there was a break or the impedance got too high.

Good luck with your next replacement. I have had a PM for 35 years now and 7 replacements. Should be nearing number 8 within the next year or so.

Best to you and please don't worry, let your dr worry about your leads.

Gellia

Thank you

by paceguy - 2010-10-21 09:10:41

Thank you both Frank and Becky,

This is helpful and help me put my mind at ease.

I am more siding with you on this because the last thing I want to do is to get a lead replaced. However, logic would tell me that the longer the lead is in, the harder it will be to extract when it is time to take it out. So, if I were to wait to have it replaced, and shoud i be fortunate enough to not have to replace either lead until the next generator replacement, the extraction would be that much harder. I know there is always the option of keeping the lead in, rather then extracting it as it minimizes the risks, but because i am still relativley young, from what i gathered from other comments on the sight, keeping the leads in could potentially put me in a compromising situation later in life. I am trying to think through this long term, rather then just short term, and is why i am somewhat torn on the issue. I woud imagine there are a few different schools of thought to this and is why i wanted to get some extra points of views from actual patients

thank you both again for your comments, it is greatly appreciated

leads

by Tracey_E - 2010-10-21 09:10:49

The average life of a lead is 15 yrs but they can go sooner than that or they can last double that or more. You've already had them long enough that extracting is a bit of a challenge, a few more years won't make a difference so I would definitely keep it as long as it's working. I've been paced since 1993. I still have one original lead, had the other replaced earlier this year.

My lead that went bad started to show up impeded about 6 or 7 years ago. It was still working but it drained the battery quickly so they left it up to me and I made the choice to keep it when I had the battery change that time. It got worse last year so when the battery died this time, I got the lead replaced also. A lead can need replaced but still work, the analogy they gave me was the window open with the air conditioner running- the house is still cool but your power bill is higher. The lead worked but since it was impeded they had to crank it way up to get the signal through and the battery didn't last long. I have a lot of years of pacing ahead of me so I wanted to put off adding another lead as long as I could.

We did not extract my bad lead. They did a venogram first to make sure there was room in the vein and that there wasn't too much stenosis then put the new lead in there with the others, capping off the bad lead and leaving it in there for now. When the other one goes or I run out of room, then I'll extract it all and start fresh.

Ease of replacement

by ElectricFrank - 2010-10-22 12:10:07

As I understand it after a year or two at most the leads are about as scared into the blood vessel wall as they will get. In your case I agree with Tracey that time won't have any effect on the easy of removal.

frank

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The experience of having a couple of lengths of wire fed into your heart muscle and an electronic 'box' tucked under the skin is not an insignificant event, but you will survive.