Got Surgery: Aveir Dual Leadless

I had promised to do a write up after my surgery at the Cleveland Clinic which was very long and complex. Just a reminder I am Canadian so this was out of necessity due to poor care and lack of technology at home, including lead extraction volume.

It turns out that the only lead I had working to my ventricle was also fractured, and being pace dependent this could have had catastrophic results. I had had ongoing buzzing as well and was told at in Toronto it was probably in my head (by my previous electrophysiologist) and in fact was my battery at end of life.  Imagine...

I had of my 4 old leads 1 and a half removed. The old ones (1989) upped my risk level too much given all the other things I needed to have done and could have resulted in death or open heart surgery. I discussed this in great detail with my very skilled surgeon and we agreed to leave those.

I had the old pacemaker, which had fallen out of pocket (reported by my Boston doctor) and ignored at here retrieved and removed and my surgeon. He removed some calcification and tidied up the old existing leads and stitched up that incision.

The dual Aveir leadless (one for each chamber) was sent up through a catheter in my groin. Given the old leads, he had difficulty placing them for synchronicity but managed to get it with excellent outcome. 

My only minor complication so far is that the groin incision (from catheter) has opened since I got home (we drove back as it was too risky to fly) so I am taking it easy and hoping it closes, cleaning and applying loose gauze.  If anyone on the boards has experience with this and can help, I am all ears.

What is it like having the dual leadless?  Like being alive again. I was left with only ventricle pacing for over 4 years. When I wake up it feels like I have really rested, I am not tired at 7:30am.

So, if you are considering this - I feel for those of us with a complicated lead past and wanting to be more mobile and lifeful - it is a plus. For myself, I realize I may need a new atrial one in 5 years but I will have had 5 full years of growing my practise and living and I already know the next version is being worked on.

I have lived a chunk of my adult life with fear of these broken leads and now that is over.

The surgery and testing at Cleveland Clinic is exceptional.  They are extremely busy and you have to factor that in when you are there for testing, etc.

The surgical team all took time to speak to me and discuss things.  I was an all day case.  So, even late, late that night the surgeon came and spent time to personally go over what had happened and my expectations for the next bit.

I am back at end of July as Abbott feels it is good to get interrogation to max the 2 pacer batteries after some use.

Back to healing.

Cat

 

 

6 Comments

glad to hear

by new to pace.... - 2024-06-27 22:43:24

Thanks for sharing.  Good to hear you are feeling better.

new to pace

Groin incision opening up...

by crustyg - 2024-06-28 03:58:59

My first ablation, the groin incision wouldn't stop oozing blood (obviously fully anti-coagulated) and I had to have a purse-string suture placed to stop the bleeding.

Great to hear such a good outcome, and a powerful reminder (if any were needed) that experience and focus on patient outcome makes the world of difference in healthcare.

Glad it is behind you

by Gemita - 2024-06-28 04:34:18

Cat, thank you so much for taking the time to update us on your complex treatment at the Cleveland Clinic. I am so pleased this is behind you and that you can start to heal and to think about other things.  I wish you every success with your leadless devices.

Thank goodness you sought expert timely help with only one working lead which was found to be fractured in any event.  I am sorry you had such a struggle to be heard and believed.  I was interested to hear about the calcification found on device removal.  You are the third member to mention this recently.  I wonder what they will find when they open me up.

Catheter access through the groin can be uncomfortable and take time to heal. I would ask for advice if you haven't already done so, or to go through your urgent care services to make sure that the wound is protected adequately and that you will not suffer any significant blood loss or other vascular complications if things don't improve quickly for you.  Take good care 

wow!

by Tracey_E - 2024-06-28 11:15:42

Cleveland sounds amazing! I'm so glad to hear you are feeling good with the Aveir. 

So, am I understanding correctly that they did a partial extraction?

I appreciate the detailed follow up.

Extraction

by Cat111 - 2024-06-29 07:58:17

Hi Tracey,

Yes - I have had complications with leads from the get go.  The oldest ones, my surgeon felt were not worth the risk, and he felt confident he would place the leadless without interference of worry.  My newest lead (ready to fracture as well) and the second newest were extracted - the latter only part as it disintegrated during the process. He left a couple of cms on the very old ones in case down the road there is a new way or easier way to extract. This is something no one has every done for me - make a plan for down the road.

Many people get this many out and some are going leadless and leaving in - I think the surgeon you have makes all the difference.

For myself, although not the deciding factor, this was an enormous financial investment for me, so I wanted a great outcome but not add unnecessarily to the burden. I did ask my doctor/surgeon what he would do at my age as well.

I hope this helps - I know you are considering leadless and extraction soon.

 

Take care.

 

Cat

thanks

by Tracey_E - 2024-06-29 15:54:10

Super helpful, thanks!

My ep spoke with the high risk ep about me. I have a call with him on Wednesday to discuss. I'm still hoping to clean it all out, but not sure that's realistic. Everyone I speak to who has leadless with existing old leads makes me feel a little bit better about going that direction if we can't extract. 

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