Lead Damage

Hi everyone,

I am 33 years old and have had my biotronik Cylos (duel chamber) pacemaker for a little over 2 yrs. I got my PM interogated on thurs, and the Cardiologist said that my atrial lead needs to be replaced bc it is being pinched and slowly fracturing.

I will have to go in for surgery to have it replaced and I am nervous as to what will happen. He is hoping to leave the old one in place, but may have to extract if need be. At the same time he will also change the battery. How long is recovery, and what are the risks?

Thank you so much for your help!!!

Christine

10 Comments

been there

by Tracey_E - 2010-03-19 06:03:23

I just had that done in January. I've had mine a lot longer than yours (16 yrs) so we were concerned stenosis would be a problem and the new lead might not fit but it was a piece of cake! I had a venogram first to verify that there was room in the vein. Super easy, it's just putting dye in an iv then take an xray. There was plenty of room, so they simply added the new lead on top of the old leads when they changed out the battery. They can usually fit 3-4 leads in a vein. Some drs are starting to extract and start fresh but many still leave the old leads alone, esp when there is room to fit a new lead with the old ones. If the lead hadn't fit, I was going to move everything to the right side rather than extract.

Same risk and recovery as your first implant. Actually, recovery is a bit easier because you already have the pocket formed for the pm itself.

Is it working now? Mine was fractured but working, it just drained the battery very quickly. We waited until the battery died to do the surgery.

Good luck!!

Thank you!

by bini - 2010-03-19 08:03:24

Thank you so much Tracey! I think they are planning on doing the dye first to see if the new lead can fit. I just can't believe my lead fractured so quickly!

My PM is working, but causing problems. I have an illness called POTS which causes me to faint, which is why I have my PM. i am fainting alot more since the lead problem.

Thank you again, it eases my mind to here from a patients point of view!

Advice

by jvaltos - 2010-03-19 09:03:11

This is no substitute for you own physician, but as an implanter myself, let me make a few suggestions.

1. The reason the lead is 'failing' is likely due one of two things: lead was pinched under the subclavian vein (which may have to do with how it was implanted) or the stitches were put in too tightly.

2. You are VERY young to not have that extra lead removed. I would send a patient like you to a referral center and have the atrial lead removed now versus 10-15 years from now.

3. The venogram can be done and if the vein is narrowed, then it can be safely ballooned open and then a new lead placed.

Good luck0
JV

you're welcome :o)

by Tracey_E - 2010-03-19 09:03:30

Glad I can ease your mind! I knew for two years that I needed a new lead so I had lots of time to study up. If yours is not working right, it's time to fix it! I was all worried about the possible complications but it was really easy, lots of worry and research for nothing :o)

If they're pretty sure the lead will fit- and after only two years there's no reason to think it won't- they will probably do the venogram at the time of the surgery. Ask your dr what his back up plan is if it does not fit on top of what you have so you know before you're under any anesthesia.

It's unusual for a lead to fracture so quickly, but it's not unheard of either. I'm still using my original atrial lead, only the ventricular fractured. Theoretically they can last a lifetime. I'm hopeful what I have will last a good long time! I'm 43 and plan to be pacing for a lot of years to come.

curious

by Tracey_E - 2010-03-19 10:03:50

JV, I'm curious why you'd expect her to need an extraction in 10-15 years, and why it would be better to do it now? Maybe it's because I've been paced since long before extractions were even an option, but my thoughts are that I want to put it off as long as possible because the technology gets better every year, and the longer I wait the more drs have time to become highly experienced at it. Part of me is hopeful that my leads will last long enough that it won't ever be necessary. If a lead goes in another 10 or 15 years and another won't fit, who know what technology will offer then? I've got one lead that's 16 yrs old and still going strong, and we have other members here with leads much older than mine that are still working. I've heard 20-25 yrs for average lead life, but never as short as 10-15. Thanks for your thoughts!

all will b ok n a wink of an eye:)

by Cheldhaye Chill Day - 2010-03-20 01:03:50

all u need to do is TRUST UR DOC that's what matters most...if u have d confident on him then everything will b okay. we r on a changing world n so s technologies n f your PM was fractured then u can have your schedule to your doc to do d fixing thing. it wont took much of your time....no need to worry much bcoz as what Rev. C. Callahan it's just a piece of cake...we have a more hi-tech gadgets to do it and a more experienced doctors to do it as well:) good luck...curing thing wont take long as well...although it depends on ones personal attitude mean how one copes up with the pain thing effect...

At Tacey's comment

by jvaltos - 2010-03-20 03:03:01

The reality is that as young as she is, I would attempt to extract the lead now as it will be easier to get it out than waiting until later. It's only been in a few years and sounds broken.

This is especially important as she will need a pacemaker for many years and IF she needs another lead....#4, then you may be stuck moving the whole system to the other side at a relatively young age....

Realistically, the subclavain, axillary vein can take 4 leads, even with an ICD lead in there, but at this age, I would look to the future and expect a lead failure or upgrade during which time having that lead out would be beneficial.

Good luck-
Dr JV

Thank you!

by bini - 2010-03-20 06:03:43

Dr. JV,
Thank you for the advice, I see what you are saying and I will discuss this with my cardio and see what he thinks!

Christine

Again Thank you all so much

by bini - 2010-03-20 11:03:48

Thank you all so much for your help and advice! You all have eased my mind so much. The plan thus far is to to do the dye during the procedure, I think I would rather have it done before- for piece of mind!

I still don't have a date set bc I have a local cardio here in RI, but I see a specialist in Ohio who is the one who installed my PM!

Again thank you, you all are wonderful and so helpful!

Christine

Piece of Cake

by ccallahan - 2010-03-20 12:03:28

Bini it will be a piece of cake. They can put four or more leads, in some cases from what I was told. Some people have 4 lead PM's in already. You will do fine. We will all be behind you and I will definately say a prayer for you.

Rev. C. Callahan

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