lead resistance question

Howdy -

My batterie is getting low, and I'm having my PM replaced early next year. A complicating problem is my atrial lead seems to have too much resistance. My Doc thinks it could be a loose connection at the PM, or the lead has gone bad. I've had two ablations over the last three years. I'm curious if it could have been nicked. ALSO: if the lead is bad, but still working, would it be better to just keep using it and see what happens? It would be nice to have the old one removed, but the Doc thinks it should stay in. I don't like the idea of all of these wires flopping around if they aren't doing anything. Any thoughts? Have a great holiday season! Jim Jim

5 Comments

Extra Lead

by Good Dog - 2015-11-29 03:11:27

If you currently have two leads and one goes bad, it is common practice to cap the bad lead (leave in-place) and insert a new one. If the lead is bad, but still working, they will not re-use it when you get a new generator.
You have the option of insisting that the bad lead be removed. However, that surgery is quite risky when compared to leaving it in-place.

Sincerely,

David

leads

by Tracey_E - 2015-11-29 06:11:04

Yes, increased resistance is a sign a lead is starting to go bad. I had one do that but it was still functioning so when we changed the battery I chose to keep it and just keep an eye on it. The downside to doing this is if the resistance is up, they have to turn up the juice to get the signal through which means a shorter battery life. Mine deteriorated further so when I had my next replacement (I'm on #4 now), we also replaced the lead. It was 3 years between first finding out about the bad lead and having the first replacement, then another 3 years until the next replacement and getting the new lead, so I had a functional but impeded lead for 6 years.

I had plenty of room in the vein so I chose to leave the old one in and add a new one. They don't flop around. They are held in place securely with scar tissue and they cap off the old one.

Another option is to remove it, however, as David said, it's a much more involved surgery. They don't just come out after the first year or so. You'll want a specialized surgeon experienced in extraction, most likely not your regular surgeon. They use a laser sheath to go in millimeter by millimeter and remove the lead from the scar tissue. I am young enough that I expect to outlive this set of leads so I chose to put extraction off as long as possible so that when I do eventually need it, that next set of leads might be my last. Some doctors prefer to extract and start fresh, some prefer to add, some let it up to us.

I've never heard of leads being damaged from ablation but I guess anything could happen. Average lead life is 15 years but that's just a number. Some need replaced after a handful of years, others go much longer. Unfortunately, they don't last forever.

wireless

by Tracey_E - 2015-11-30 02:11:06

The wireless is single chamber, does not work with existing leads, and is not available if you are dependent. That leaves out most of us here, but it's still exciting technology.

Lead extraction

by heckboy - 2015-11-30 02:11:08

One of my leads was partially pulled a year into my 1st PM (now on #3). To keep me pacing, they turned up the juice and my generator life was only 3 1/2 years. If it was me, I'd let the new lead.

I had my leads extracted about 8 years ago. Because of my relative youth (45 at the time), we decided to remove the old leads rather than leave them in. Normally, old leads are capped and left in, but the younger you are, the more leads you will accumulate through life, so my DR. suggested I have them removed.

Hope this helps. In retrospect, I was glad to not have the leftover hardware inside of me.

Did you heard about the new wireless PM? It;s only for single changer pacing, but it sounds amazing.

What to do, what to do...

by jimkirschvink - 2015-12-02 02:12:56


Thanks for your advice. My last ablation was 9 1/2 hours on the table, so I'm not thrilled about having a lot of down time. I'm kayaking the Grand Canyon in April, and I want this resolved. I'll be 60 in May, and overall in good shape. I would rather have it out, but I'll consult with the Docs. Hopefully, it's just a loose connection where it connects with the unit, but I'm not holding my breath. Best wishes to all! Jim Jim

You know you're wired when...

You’re officially battery-operated.

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