Hmmmm...

I've been through pretty much all the stuff. However, I have a replacement scheduled the day before St.Patrick's Day and was just curious, I have the same lead that I had like twenty years ago. Will they change it? Obviously, questions I haven't had an opportunity to ask my surgeon.

5 Comments

Old Leads

by ElectricFrank - 2012-03-10 01:03:37

Hard to say. Those leads may not be compatible with a modern pacer. Then again there could be an adapter. If it were me and they seemed OK I would go for keeping them.

frank

Old is right!

by Gellia3 - 2012-03-10 08:03:04

Hi,
My leads are 30 years old now. I hope to keep them forever! As my EP says, "If it ain't broke, don't fix it".

I have had no compatibility issues to date and have had 7 replacements with the last one just five years ago. So far, so good! I hope it's the same for you.

GOOD LUCK!
My best to you,
Gellia

Want to read a scholarly work on this?

by donr - 2012-03-10 09:03:04

Last night, after reading at least three posts on lead extraction questions, I went to Google & found this PDF format document by the Heart Rhythm Society. All sorts of interesting info in it. Like what are the conditions for removing old leads. Criteria for a surgeon to be adequately trained & experienced in lead extraction. Mortality rates for the procedure (under 1% for an "Experienced" surgeon). It's a 45 page document, well written & truly interesting - IF you are a PM Host facing a potential lead extraction. recommendations on what type institution you should go to for the procedure.

http://www.hrsonline.org/news/media/press-releases/upload/leadextraction_cieds.pdf

Enjoy!

Don

Lead Replacement

by SMITTY - 2012-03-10 12:03:07

Hello Chappel1978,

You have received some good comments on lead replacement. Now I'll add some that come from letting my mind do a little freewheeling and I'll admit some of which may be irrational. But I'm of the opinion leads are, or not, replaced for several different reasons and I will name some of them.

Let's start with the Dr. He may be from the old school and does only those things that are a medical necessity for the patient and removal of the old leads to implant new ones would be far down his list of things to do. If the Dr happens to consider the patient as just another customer you may get a new lead if you have good insurance and/or well healed. Or if he thinks he needs the practice in lead replacement and you are considered a low risk patient you may be a prime prospect for some new business. Or you may not get a new lead if your twenty year old leads are compatible with your new PM and you do not have the pluses listed above.

Other considerations for whether to change out your leads is if the old ones have high resistance, which could make the need for higher power settings which would of course deplete the battery faster.

Another consideration is after 20 years it can be safely assumed that those leads are well embedded in the surrounding tissue their removal may be considered too difficult. To go with that if the veins the leads use as a conduit to the heart are large enough to accommodate additional leads, the old ones may stay and new ones are put in simply because why kick a sleeping dog.

Another consideration for a lead change that has nothing to do with condition of the lead itself is the lead's contact point with the heart wall. In some people these contact points develop scar, or some other type deposit which can retard the flow of power to the heart wall. This condition would be detected by checking the impedance or resistance of the lead. My point here being that poor current flow from the PM to the heart does not necessarily mean the wire itself is no longer suitable for the job. My thought is that it is probably just as easy to replace the lead as it would be to go in and break that lead loose from the heart wall and relocate it.

With that I'll stop after saying I am not predicting any of the above comes close to determining why your leads are or are not replaced. But today it is raining outside and I cannot go outside and play and anyway I confined to my chair for a few hours while I use my O2 concentrator. But I thought I may give you a few things to consider when you talk to your Dr as I don't think all of the reasons a lead may be replaced follow any hard and fast rule.

I wish you the best,

Smitty

Reality Check

by ElectricFrank - 2012-03-13 01:03:46

"Only " a 1% mortality rate. Wow. So next time you are in a church, theater, aircraft, where there are about 100 people consider this. If all of the group had a lead extraction under the best conditions one of them would be dead at the end of the day.

Hmmm!

frank

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