Ventricular lead not responding

I had my first dual lead pacemaker put in a week ago for sick sinus with bradycardia.   I had a checkup with my regular doctor and the found my HR to only be 43.  He immediately set me up with a pacemaker check.  They could not get the ventricular lead to respond.  I was told the lead would need to be replaced and was sent for chest X-ray.  The LPN called later and said the doctor did not see a lead fracture and wanted to check it again in a week.  Has anyone had this issue and found that waiting fixed the problem?  

3 Comments

Doesn't make sense

by crustyg - 2021-07-30 08:20:55

The issue (low HR) *should* have nothing to do with a working/not-working vent lead, *IF* you have only SSS (+/-CI).  Unless you have AV-node problems, a properly installed and configured PM with RA lead should fix you.

A non-working vent lead a week after implantation won't magically get better.  Either the lead is faulty, not-implanted into heart muscle correctly, or not connected to your PM correctly.  That's it.  It needs to be fixed ASAP, before it causes any other issues.  Post Vent-lead implantation you should have a PA and lateral CXR - the lateral is vital to ensure that the RV lead isn't implanted into the anterior wall of the RV, but is implanted into the inter-vent septum somewhere.  You can't really *prove* this with a PA (or AP) view. And you can't see a faulty pacing lead with a CXR - they don't snap in two.

 

Is there a problem ?

by Gemita - 2021-07-30 10:50:15

KingCRW,

I am not sure that waiting will fix a problem if there is one?  I would be more inclined to perhaps think that there wasn't a problem in the first place.

You say your general doctor took your blood pressure/heart rate.  Did she/he do this with an automatic blood pressure monitor, since these monitors can give some false readings in the presence of something like an ectopic beat.  I often check my blood pressure and heart rate during rhythm disturbances and my heart rate can be down in the forties, according to my automatic monitor, whereas the pacemaker correctly reads the irregular, pausing atrial or ventricular beats and doesn't register them as skipped beats like my automatic monitor.  Could this have been the problem I wonder?    I am though confused because your team initially said your lead would need to be replaced?

How do you feel?  What symptoms do you have? 

Lead not respomding

by Kingcrw - 2021-07-30 12:02:56

The general doctor checked manually.  I am rather confused also the EP and LPN said it would have to be replaced.  The EP tried to get the lead to respond and could not.  This entire thing has felt strange to me.  I have never spoken to the actual cardiologist to get any questions answered.  I have been told he is one of the best in our area, but I think I will be switching to someone that can take the time to explain things after this gets fixed.

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