Lead extradition

yep

by Tracey_E - 2017-07-13 09:31:31

Is the lead working? When it happened to me, they were able to adjust the settings and keep the lead working so I could wait until the battery needed replaced. Because they had to crank up the juice to get the signal through, the battery depleted at about twice the usual rate. My other lead was in good shape and I'm relatively young, so I chose to put off extraction as long as possible, hoping that once I do need to extract that the next set of leads will be my last and I won't be facing extraction twice.

Yes, it's harder as they're in longer, but the lasers they use get better and better, leads get smaller and more durable, doctors get more experienced. Even ten years ago it was very new and considered high risk, now it's still considered serious but nothing like it used to be. I'm already going to be complicated to extract, waiting won't make it more so.  My doctor agreed, so we did a venogram (iv with dye in the cath lab) to see if there was room in the vein to take another lead. There was, so we simply added the new lead and capped off the bad one. I won't be able to do that again, so next time a lead goes I'll be looking at extraction. That was 7 years ago, my other original lead (now 24 years old) is still going strong. Some doctors will disagree with this approach, they prefer to extract and start fresh for the reasons your doctor stated. Do your homework, ask your questions, then decide what's right for you. 

A question for your surgeon is how many extractions does he/she do per year. Ideally you want someone who does 100+. They will always have a cardiac surgeon on standby in case of emergency. Ask how many times they had to use them. If you know you are going to be complicated to extract, you may want to consider traveling to someone more specialized. My doc is already very specialized, head EP at a major university hospital with a large congenital practice, but he has already told me that when the time comes he is going to refer me to a colleague who has even more experience in complicated cases. 

Lead extraction

by Finn - 2017-07-13 11:34:12

Thank you Tracy with the info and questions to ask. Yes the lead works but has (episodes), noise as it's called. It is the lead that is used less, 2%, lower chamber, vs upper 95%.

for info sake, I'm 56, , not sure if he wants to cap it or extract, timing, this year for two reasons, even though this lead is not used that much there is synchronization between the two, secondly I don't know if I'll have health coverage next year, I'm on Obama care, California.

didnt think about having a cardiac surgeon on call, ahh, lol

pacing

by Tracey_E - 2017-07-13 11:46:58

I use my v lead for every beat, that's the one that went bad, insulation ruptured. They also used the word noise, likened it to running the air conditioner with the window open, the house still cools but the power bill is high. 

I'm 50 now, was 42 when the lead issue first came up. Average lead life is 15 years but they can last 30+, or not even 15 (as you learned). I'm at 24  years and counting without extraction. 

Insurance is so hard for us. I've made more than one life decision based on insurance coverage implications. 

Lead

by The real Patch - 2017-07-13 13:00:23

I'm wondering if you have one of the recalled Riata leads? I wouldn't keep it, those can completely fail without any warning signs. At some point that crap has to come out so may as well get it done, waiting only makes it harder and reduces your options.

I had a St. Judes device with recalled Riata lead in the ventricle for 7.5 years. For the novices this lead has the helix contact and screws into the heart wall. They popped out the leads and device with no problem whatever. Did have an OR and a Cardio-thoracic surgeon on standby just in case but no big deal. Oh and for the record, my EP had a seeing eye dog so how hard is it really?

Lead extraction

by islandgirl - 2017-07-21 23:19:51

If you get an MRI compatible box, make sure you specifically ask aobut loose leads.  My EP told me I could not have an MRI with loose leads, so they extracted my ventrical lead when I had to get upgraded from a PM to an ICD.  Took awhile, and my chest was sore afterwards, but make sure you find somebody with experience.  Added about an hour to the procedure.