New biventricular lead misplaced

I just got a new St. Jude biventricular pacemaker to replace the dual lead Medtronic due to worsening ejection fraction(40%).   The doctor told me he was able to place the new LV lead in the perfect place.  After the implant, while I was in recovery, the new LV lead became displaced.  Two hours later I was back in surgery.  The doctor tried to reinstall the lead in the same(best) location but was unable to due to clotting in that area so he placed in in another location.  He later informed me that it was not the ideal location and that the benefits of the 3 lead pacemaker probably would not be achieved and wants me to wait 6 months and get a new echocardiogram.   Anyone else been through this and is it possible at a later date to have the LV lead repositioned in the ideal location to achieve optimum results?

Needless to say this has been very disappointing for me and I am not sure what alternatives I have.  Thoughts appreciated.

1 Comments

His bundle pacing

by AgentX86 - 2019-10-14 22:49:22

It is not true that "all ventricle leads should be implanted in the HIS bundle".  Dual ventricle leads are still very common and in no way inferrior.  OTOH, it's also true that it can be difficult to place the LV lead of a CRT pacemaker.

Biventricular pacing isn't normal for those with heart block and a normal EV.  Something like 25% of these patients will see PM induced cardiomyopathy, which calls for a biventricular PM.  At 25% of the population, I'm surprised every doesn't get a His or CRT pacer but it doesn't happen.

 

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