Lead Punctured My Left Ventricle

Hi, this is my brand new entrance into the Pacemaker Club! I just turned 60 on March 5. I received a Medtronic pacemaker on March 24. Less than 48 hours later I  began to have sharp stabbing chest pains.  The pains were not related to the suture site or the skin around the pacemaker.  I called my cardiologist's office and they said it was related to post-surgery discomfort. For the next week they would come and go. My cardiologist scheduled an appointment & he said all was well. He ordered a chest-ray and that was normal.  After 6 days his office called to say that my pacemaker transmissions were "off" & to come in.  I did & they determined that one of the leads was bad.  They said someone would get in touch with me soon about having an additional surgery. Unfortunately, the next morning I felt like something was pushing down on my chest and then occasionally stabbing me. My daughter took me to the ER. Another normal chest x-ray. The attending ER ordered a CT scan with contrast after that ...  turns out the bad lead had punctured a hole in my left ventricle.  The sac around my heart was full of blood.  And the pacemaker was shocking me rather than doing it's normal "pacemaker" job. They did emergency open-heart surgery to repair everything.  Wow! They said it happens rarely, like a once in twenty years event.   My daughter saved my life.  The attending ER ordered the right test and saved my life.  The cardio-thoracic surgeon saved my life. It has been a month now since the open-heart surgery and I am filled with gratitude. The pain that happened with the bad lead from my pacemaker was the worst.  Recovering from open-heart surgery was rough but it meant that I was still alive.  

5 Comments

Wow!

by arent80 - 2021-05-04 01:11:39

What a story and thank god you're here to tell it. I'm so terribly sorry this happened but again thank god you're still here!! I have kind of a similar story.... For most of my adult life I've never had anything more than a cold. On 9/28/2019 I felt weak and lightheaded. I went to the ER that night and nothing was abnormal. The ER doc was sitting there eating an apple I think and said have you ever had your heart checked? I said HUH? Why would I need my heart checked. I'm only 39, what could be wrong with my heart? Well he gave me a Zio Patch and guess what? ONLY when I slept did my heart rate drop down to 21BPM and it would pause for Up to 11 seconds. I still get the chills when I think about it!! Well from there the rest Is history and I'm so thankful that the ER doc took the extra step just to be sure. If he didn't I might not be here to Tell this story. God bless and stay safe! 
 

Alejandro 

what a story

by Tulp - 2021-05-04 22:19:01

Wow, that sounds truly scary. Im sorry you had to go thru that, and happy your daughter took you to Else-Roos.

It is great that you speak so optimistically about it. Thanks for sharing.

I hope you will recover fast,

 

 

Curious

by AgentX86 - 2021-05-06 21:24:14

I'm curious.  Maybe Crusty can help me out.  How does the left ventricle wall get punctured?

Hmmm.

by crustyg - 2021-05-07 11:24:20

I had already messaged privately about this, so pardon me for posting this in public.

I think it's much more likely that the RV was punctured: LV penetration is not usually survivable for very long - high pressure system, cardiac sac fills with blood quite rapidly =>tamponade =>The End.

RV puncture, low pressure system, takes much longer for serious tamponade to develop.  Still fatal if left untreated.

RV is easy to puncture if an active-fixation lead is screwed into the anterior wall of the RV which is really quite thin - it's meant to go into the septum between RV and LV - nice and thick.  That's the whole point of the lateral CXR after lead implantation - to prove that the RV lead *isn't* in the anterior wall, which you can't really see using chest=>back fluoroscopy on the table.

CRT lead to LV goes into coronary sinus and connects to LV muscle that way.  As a trans-venous lead it doesn't go into the inside of the LV (neither does an epi-cardial lead).

Happy to be proved wrong, and my apologies if spouting my opinion here upsets anyone.  Brilliant to have survived the experience of cardiac tamponade - it's a real minutes-matter emergency and not something that anyone wants to have to go through. You can save the patient's life with a big syringe and a looong needle in ED (if you know what you're doing), but the definitive fix is crack the chest open and oversew the hole...

Left V

by tch2rd2 - 2023-02-01 11:32:50

At the risk of being rude, I went back to investigate and the notes read LV penetration.   My original cardiologist's office closed ranks pretty quickly and had all their bases covered by the time I was discharged from the hospital.   My records were available online through my healthcare provider.  The summary had LV penetration and a bunch of gobbledy-gook.   I have to confess that I got very emotional reading those notes.  Seeing that in black & white ...  The night I had my surgery cardiothoracic surgeon talked to my family out in the parking lot (this was during pandemic) told my family that I was a miracle.  He let my husband come inside so that he could pull up my imaging scans for my husband to see.  My doctor pointed above where my puncture was... and then to a white spot above it that was on the screen.   He said, "See that little white spot?  That's what we call the Widowmaker.  If that was punctured she wouldn't be here right now."   All I know is what the attending RN said after my CT scan... "Lori you've got three problems.  One, one of  your leads moved and punctured a hole in the lower left portion of your heart.  Two, there is blood filling up the sac that surrounds your heart called the pericardium.  Three, your pacemaker is still shocking you.   We are getting you prepped for open-heart surgery."  My daughter wrote down what he said and then showed him her scribbled notes.   She asked him is that was correct and he said that it was.   This was during the pandemic when you could only have one person with you in the hospital.   My daughter wanted to write down the information accurately because she knew she'd have to repeat it to everyone.  

      Crusty it is possible that everyone heard it wrong and recorded it wrong.   After my experience, anything is possible.  It was very traumatic at the time and sometimes I still get teary about the experience and yet I still feel like a miracle.   Every day.  Even the colors are brighter.  

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