Very upset ....again

Hello all,
I had my pm 27Nov and was delighted with it until 28Dec when the follow up showed the ventricle lead was not seated. Had a lead revision 4Feb and just gone for this follow up and it still is wrong. Now I am to have a active fixation lead sooner rather than later.
I have been so careful with movement - the pm was stitched in and the Dr gave me a bit of extra slack so I don't know what has happened. The nurse said it might be my anatomy causing the problem - does anyone have any ideas about this please? Are there any extra risks I need to be aware of with this type of lead?
Look forward to any information you can give me.
Sue (in uk)

5 Comments

Thank you

by Suzie_G - 2013-03-28 01:03:01

You are all very kind. I thank you for the trouble you have taken and feel a little easier now about this situation. Sue x

New Lead

by SMITTY - 2013-03-28 01:03:30

Hi Sue,

I think Tracey said about all that is really important to say about your situation. But, I'll repeat some of it. Some of us are difficult to get leads to stick. In your case (I'm mostly guessing here) they are using the lead with the "corkscrew" tip and the dr has to get that corkscrew deep enough into the heart wall to make it stay, but not so deep as to puncture the heart wall. As you can guess under the best of conditions getting a lead to stick in place has got to be difficult.

There have been a couple of times since I got my first PM I have had heart caths. During these caths I have been lucky enough to be able to see my PM leads on the monitor while the dr was checking out heart arteries and putting in place a stent. I was amazed to see that every time my heart beat the PM lead flexed. It was very evident that plenty of slack was left in the lead so it could flex without putting pressure on the lead tip, which happens to be the corkscrew type tip. Just to make all this seem a little more implausible when I got home I got out my handy-dandy calculator and tried to add up the times those leads (I have two) get flexed each day with a heart rate of 80 bpm, my low PM set point. For each 24 hours I get a number of at least 115,200 flexes. Multiply that by 365 days a year and the number is 42+ million. Now I've had my PM for almost 13 years and I don't think I even want to know how many times those leads have flexed and are still going.

I guess what I'm trying to say it is to me it almost a miracle that any of us have leads that stay in place. Now to give you a little more think about go to this web site:

http://www.sjmprofessional.com/Products/Intl/Pacing-Systems/Tendril-SDX-Active-Fixation-Leads.aspx

You can see what one brand of Active Fixation Lead looks like.

Please understand I'm not trying to increase your anxiety over your lead problem. But if they are making a special lead for situations like yours, you are obviously not the first one to have this problem. The fact that your dr knows about the Active Fixation Lead says he has seem the problem before and knows how it can be fixed.

Good luck,

Smitty

lead

by Hope - 2013-03-28 05:03:22

You have received lots of advice about lead issues. While it is certainly true some of us are more prone to difficulty with them than others, there are also doctor placement failures due to lack of experience and/or kwowledge. Just because your doctor is aware of the special leads, it does not mean he is the appropriate choice for the surgery. Discuss it with him carefully, and if it were me, in light of two previous failures, I would still want a second opinion before allowing him/her a third chance. Hopeful Heart

oh no!

by Tracey_E - 2013-03-28 11:03:47

I'm sorry you've had so much trouble! It is not you and your activity. Some people's hearts just don't like the standard leads, sounds like both your and your dr have done everything right. I don't know anything about active fixation leads (have only heard of barb and screw types) but I know you're not the first member to have had problems getting a lead to stick, and all of them have had good luck when changing to the other type. Fingers crossed this next one takes care of it.

rightfully upset

by Hope - 2013-03-28 11:03:50

Hi! Sue, Before letting the same care continue to be your medical care, and for sure before performing another surgery, a second opinion is definitely appropriate. I am sorry you have had such a stressful time. Hopeful Heart

You know you're wired when...

You always have something close to your heart.

Member Quotes

I'm 43 and have had my pacemaker four weeks today. I'm looking forward to living another 50 years and this marvelous device inside me will help me do that.