Pacer/defib third lead to ventricle

My cardiologist wants to put a third lead in the left ventricle. They will have to make an intercostal incision, place the lead externally (I think) and then 'fish' the lead up to the pacemaker/difib. I have some concerns regarding risks and success of the procedure. If you have had this done would you please let me know your experience. I am in hopes that it will give me a better quality of living. Thank you.

1 Comments

Epicardial leads

by golden_snitch - 2013-05-28 03:05:14

Hi!

I have had two pacemaker leads placed that way (epicardial leads), one on my left ventricle and one on the left atrium. The incision was made just below my left breast, horizontal between the ribs. The leads were then tunneled all the way up to the pacer pocket (which was re-opened). It was much more invasive than a regular pacemaker surgery, and two incisions always hurt more than one. I needed quite a lot of painkillers afterwards, especially the first couple of days, and overall it took me a few weeks more to recover. I had a small pleural effusion afterwards which was treated with diuretics, and six weeks later developed a pleurisy. Probably just bad luck. I know a friend of mine recovered much quicker from the same surgery.

There are no problems with pacing, in fact both leads show very good performance. I was told before that epicardial leads won't last that long, and that they often have higher thresholds, but in this regard my leads are functioning perfectly. Even my doctors are surprised how well they do. What I don't like is that I can actually feel the leads rubbing when I raise my left arm, cough or take a deep breath. Doesn't hurt, but feels uncomfortable. However, I have heard that this is not the case in every patient with epicardial leads.
My surgery was done in the very late afternoon - due to several emergencies that needed to be treated first -, and I'm still thinking that not the very experienced surgeon, who should have placed those leads, did the surgery. So, maybe someone with less experience just didn't do a very good job, and therefore I have this rubbing sensation now.

Don't be afraid. You'll have a general anaesthesia, and the pain really is manageble with painkillers (don't hesitate to ask for them). Just be prepared that you need more time to heal than you did after the other pacer/ICD placement.

Good luck!
Inga

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