lead extraction surgery - others' experiences?

leads

by Tracey_E - 2017-09-24 16:43:27

If the problem is right at the box, can't they just fix it there or are the leads themselves compromised? Some doctors are faster to extract than others so do your homework and decide what's right for you. If you look up extaction in the search bar at the top right, we've had a number of members go through it with no problems.

You want a surgeon who does at least 100 a year and you can ask what their statistics are, how many times they've needed the cardio-thoracic team that they always have on standby when they do these. You may decide to travel to a clinic that's more specialized. 

I got my first leads in 1994, one went bad in 2010. I chose to add a new lead and cap off the bad one, hoping that if I can keep this set as long as possible (I'm 50 now), then my next set of leads might be my last one. Average lead life is 15 years but they can last 30 or more. I haven't had an issue since, both new lead and the working original lead are both working well.  Every year the technology gets better and more surgeons gain more experience, leads get thinner and tougher, they get closer to having wireless devices. So I chose to wait as long as I can.  My doctor agreed with my reasoning and supported my choice.

Don't be shy about getting more than one opinion. I was uncomfortable with the first one I met, felt like he wasn't listening to my reasoning for waiting, that he would be too quick to extract even tho that was not my preference if there was another option. The second one said sure we can extract, then he listened to my reasons for not wanting it yet, we discussed the pros and cons then did a venogram to see how much room I have in the veins. I picked door number two. 

Lead Extraction

by Sylvia1 - 2017-09-24 19:23:10

My husband had his leads and device removed 2 years ago and had new leads and ICD fitted.The procedure took nearly 8 hours (a bit of scar tissue-had been in just over 2 years).He was totally exhausted but next day went home.

extraction versus waiting

by primaldiva - 2017-09-25 01:38:32

Thanks you both for your comments.

My EP said average lead life is 10 years, and yes they could try and fix the sheath, but since I have had the thing for 8 years the thought was why not replace now?  I am very concerned that artifact is causing my ventricular pacing to rise up above 30% again; I did suffer some pacing induced cardiomyopathy when they had me in Rate Response mode unnecessarilly and it took several years to for my heart to calm down and the Vpacing down to 25%.  Its back up to 33% and we both agreed that was probably due to the lead rubbing on the other.

I am inclined though to think about fixing the sheath for now though.  Thanks I will seach the archives as well.  Andrea

Lead extraction

by Good Dog - 2017-09-25 07:52:31

When your doctor says why not replace now, I can't help but think that is a pretty cavalier approach. I have one lead capped, an active one that is 20 years old and an active one that is 30 years old. The cleveland Clinic doc told me that they don't remove leads unless it is absolutely medically necessary. The reason; risk. They are among the best in the business. Although their complication rate is only 0.5%, he advised that there is more risk in removing than leaving in place. Of course they remove them when they need to.

 One might think that 0.5% is pretty safe. Yeah, unless you happen to be the one in the 0.5% category. 

So yes, extraction has become much safer than in the past. If necessary, you shouldn't give it an extra thought. However, there is nothing wrong with putting it off till later either.

I wish you the very best!

Sincerely,

David 

lead extraction article

by zawodniak2 - 2017-09-25 12:31:51

http://circep.ahajournals.org/content/3/4/409

Just some more info to help make decision..---keeping in mind this was seven years ago..   Like Tracey indicated,  results from a venogram seems very important in the decision..

              Rodger

I had my PM and leads extracted

by valley01 - 2017-09-25 17:04:05

... a couple of months ago and had no problems. I only had them in for just under 4 years so they had some scar tissue to work through which just took time. I could have left it in but the risk of infection, while low but I am assuming I have many years ahead of me, scared me. My EP said it's a relatively easy procedure when you don't have 10+ years of scar tissue and/or an infection. If I left it in and did get an infection at some point later on it would be much more complicated. My surgeon has been doing this for several years - in the 2 years at the hospital I was at and he had never needed the Cardio-Thoracic team (although they still make you meet with them and prep you for surgery as if you will need them). My surgeon was also not my regular EP because my EP didn't do extractions but he highly recommended this guy. I trusted my EP from the beginning and when we discussed the pros and cons I asked him flat out if he were me would he have the extraction and he said yes with no hesitation.

Right Vent. Lead Extraction

by natlat - 2017-12-01 08:07:15

I just had my right ventricular lead extracted.  The R wave was down to 1 and my lead was making alot of noise. They had to continue to crank up the "juice" to work and sense properly.  Another smaller hospital originally put this lead in the apex right in a scar there 3 years ago which I wonder why they would do that instead of on top of the scar of a bit away from it?? My new lead was put in in the apex but next to the scar.  I have a scar in the apex and no one could diagnose me nor why.  I had an ablation two years ago in the vicinity of the apex lead which fixed my VT and I have been off meds and running and vt free ever since.  However the lead in the apex was failing and they think that it could be caused by fibrosis and/or the fact the ablation was in the vicinity of the lead.  They are sending the lead to the facility to be tested.  

Is fibrosis a common cause of lead problems?