Atrium lead dislodgment

unlucky

by Tracey_E - 2024-11-04 10:35:35

It's odd for them to dislodge after the first 24-48 hours. It could have been in a bad place, it could be that the heart wall didn't like the type of attachment the lead had. It could have been something you did, though you were well after the healing period so probably not. The lead shouldn't have been too short, they usually have to coil the extra and tuck it behind the device so it has plenty of slack. It most likely is simply bad luck. I'm sorry this happened to you. Good luck. 

Exercise

by light - 2024-11-04 12:26:35

It would seem to me that pacemaker leads are not suited to active individuals

who exercise on a regular basis.  I noticed that the movement when pushing or manovering a lawn mower is very similar to bench press. Movements in daily life could dislodge a lead.

dislodging

by Tracey_E - 2024-11-04 13:53:47

After the first few weeks, the tips of the leads are held in place with scar tissue. After the first year, they are held so tightly that it takes a special laser to get them out. 

They are put in with slack so that any movement of the chest does not translate to movement in the heart. Pushing a lawn mower or doing bench presses can cause movement between the box and lead, but it's highly unlikely it will pull on the lead that is in the vein all the way down in the heart. They would have to be incredibly short for that to happen. 

When you see warnings about bench presses, it's not for fear of dislodgement but possible rupture of the insulation on the lead from repeated flexing. 

Second opinion?

by Gemita - 2024-11-05 01:35:38

Light, you do seem to be having difficulty moving away from questioning why this has happened and who is to blame for your lead dislodgement rather than focussing on moving forward and trying to make sure that the next attempt will not end the same way.  To this end I wonder whether there would be any benefit, even at this late stage, in getting a second opinion since I sense that you are not entirely confident in your current team?

You state that pacemaker leads are not suited to active individuals who exercise on a regular basis.  This is clearly not the case for many members here who lead extremely active lives.  However, if you are really convinced that a traditional pacemaker with leads is not for you, perhaps you should consider asking your team about the possibility of having a different system implanted, perhaps a leadless pacemaker? 

Each pacing system will have its own implant risks and there are pros and cons for both systems.  If you haven’t already done so, I would try to have a thorough discussion with your doctors about your concerns well before any revision and ask what all your options are going forward?

I really hope you can be reassured and better still that your next procedure will be a successful one.

Second Opinion

by light - 2024-11-05 04:48:13

Absolutely no need for a second opinion indeed I have opted and decided to wait for my original surgeon to perform insertion of new lead (best surgeon for pacemaker in Ireland)

It is quite easy to move on from a dislodged lead!!!  find it and fix it is my philosopy in life.

The problem is this - pacemakers are in the main implanted in more senior people who may not be as active as less senior people this is a fact and is the reason that not many people have dislodged leads.  

Lets have a poll on this forum and see how many people EVER had a dislodged lead at heart end I think the results would speak for themselves. No one knows what movement in life will dislodge a lead everyone certainly has an opinion on the matter but no certainty.

I look forward to the results of aforementioned poll.

Glad to hear

by Gemita - 2024-11-05 08:15:53

you have absolute trust in your surgeon Light.

When our website is upgraded and relaunched, we will all be able to create our own Polls and ask any question we like, without any help from a moderator. 

I look forward to seeing a Poll from you on lead dislodgement in due course.

Poll

by Tracey_E - 2024-11-05 08:48:56

I started a new poll on lead dislodgement. I'm not going to argue with you, but I predict there is no correlation at all between activity and lead dislodgement. Ask your doctor to explain it, but once we heal and scar tissue builds, it's truly impossible to yank out a lead from activity. 

Dislodgement is not the same thing as rupture.

I have had 30 years of Crossfit, running, hiking, skiing, kayaking while paced. While the majority of pacer recipients are older, you'd be surprised how many younger people have them now. They've been pacing babies for about 20 years now, so those kids are now out of their teens. Adult Congenital practice is a thing. My ep heads one of these clinics, it has 1200+ patients, many of whom are paced. I'm one of the oldest at 58. While we certainly aren't the majority, there are a lot of us out here, living full active lives with a pacemaker and leads that keep up with us.