Lead extraction

Hi everyone! Hope your Thanksgiving holiday was awesome!! I have a question...has anyone on here had the old "hook type" leads extracted? That's the term my cardiologist used to describe my 15 year-old leads. When I received my replacement PM on Oct 1st a new Ventricular lead was implanted and the old one was capped off. (I'm 100% paced and EP says I have no natural rhythm) We hoped the Atrial lead would last another few years, but it's going bad very fast. Now both of the old leads need to be extracted in order to implant a new Atrial lead. Up until then I didn't realize all the leads are in one artery. My doctor says this procedure is much more complicated and will require an operating room, cardiothoracic surgeon and full surgical team as well as himself, in the event of complications. I'm not one to be scared of surgery, but one of the pacer techs said this type of surgery is one of the most dangerous ones they do...not the most assuring news. I'd like to schedule the surgery for January, after the holidays, but then I get nervous. One of my sons will be returning from his Peace Corps mission in Rwanda in April (Can't wait to see him - it's been almost 2 years already!) and my oldest son & his wife are expecting my first grandchild in May (I'm SO EXCITED!!) - for those reasons, I've considered waiting until June or later, if possible. Thing is, it has to be done and I finally found a good doctor that I trust. Should I just go for it? Any helpful advice is appreciated. Thank you!!
Teresa

6 Comments

Hi

by Pookie - 2010-11-30 08:11:09

Hi.

You certainly have a few things to look forward to, which is great.

As far as the lead extraction, I know nothing about it, but have read and heard the same as what was told to you, that yes, it is or can be dangerous, however, with that being said, there are numerous members here who have had it done, so hopefully they will respond to your questions soon.

You said that your atrial lead is going fast...could they give you an estimate of how long it would last? As I can certainly appreciate your trying to time your surgery around your son's & grandchild's arrivals.

Just check back every day and I'm positive some of our members who have had the lead extraction done will help you in any way they can.

I wish you the very best.

Take care,
Pookie

Lead extraction

by ElectricFrank - 2010-11-30 10:11:41

First off just be sure that the team who will do the extraction have plenty of experience and have the latest equipment. There have been a lot changes such as using a laser to free the leads that can make it safer and easier.

It is pretty standard for the leads to be in the same blood vessel. It is usually a vein rather than an artery.

best of luck,

frank

Lead Extraction

by donb - 2010-11-30 11:11:45

Hi Teresa, Sorry about having anxiety of lead extraction as I almost had to have mine done a couple years ago. I did a lot of research online on the newer procedure using lazer. As you mentioned your old lead had the old hook attachment. Online you can find lots of info in referance to this surgery.
In my case I did a lot of worrying and later it turned out quite simple as they just added 2 more leads leaving my 17 year old leads in place. As you would have 5 leads and also considering much younger age is probably the reason they want to remove your old ones. One thing I would question why they can't just add 1 new lead and use the recent replacement. Depending on you Dr's opinion could also warrant a second opinion. I did that at the time and found another in Dr. who specializes in just lazer extractions with good results.
So, I'm on my 4th PM, new right chest implant, and 4 leads in place. Differant story here is age, I'm almost 79 and the balance of risk was better for me with 4 leads.
Also, many PM patients have 4 leads and no problems.
Seems like quite a few members with new installations have had lead problems, some due to poor lead attachment to heart wall, or even the area of attachment
Again, unless you have top medical diagnosis, ask lots of questions. I have 2 top Cardiologists and they kicked my lead problem around for a year. I had another factor though, I had erosion start and had to have my PM removed. So even with all tests for infection, they're never sure. donb

pacing

by Tracey_E - 2010-12-01 07:12:20

Do you pace both atrial and ventricle? It's pretty rare to be dependent on both leads. I am fully dependent with very little underlying rate also but only ventricle, my atria usually works ok and rarely paces. I would be in a hurry to fix it if my ventricle lead went bad but I would take my time about it if it was the atrial.

Ask the dr doing the surgery how many they do a year, you don't want one who does fewer than 100. The number of experienced drs grows every year so it is getting easier and easier to find one who's highly experienced. The whole cardiothoracic team is there for an emergency, don't let it scare you. The odds of needing them are very small.

Good luck!! We've had quite a few members go through it without a hitch, if you do a search you should be able to find their stories

Thank you for your comments

by TSan1961 - 2010-12-01 07:12:27

I appreciate all your thoughts and comments, it means a lot to me that each of you would take the time to respond.
Pookie, I do have a lot to look forward to in 2011 - can't wait! The EP couldn't tell me exactly how long the atrial lead will last, but it went from 380 impedance on Sept 30 (day before pacer replacement) to just over 100 at my last check on November 12th. It has given the "warning" that it needs replacement but she said she could probably work with it a few months, not sure how long.
Electric Frank - Thank you! I've done more reading about the procedure and it seems they've made a lot of advances in this area using laser tips, so it should be fine.
DonB - The cardiologist said he could NOT put a 4th lead in there, not enough room. He had to clear a lot of scar tissue and fibrous material (I think that's what he called it) from around the old leads so he could implant the new ventricle lead. Trust me, if that was an option, I'd prefer it and would have asked him to implant the new one at the same time he did the last surgery.
TraceyE - I've been told that my Atrial paces between 85 to 90% while Ventricle is 100%. So, I'm not as dependent on the atrial lead, but it does pace quite a bit.
I do feel confident with this doctor, it took years to finally find him, and I like him. I think he has the experience this surgery requires but I will be sure to ask him. (Is there a way to check into that without asking the doctor himself?) I'm thinking I should go ahead and schedule the surgery and a meeting with him before hand BUT I would still like to hear from anyone who has had this done.
Thank you all again. Take care and God Bless :))
Teresa

Lead Replacement

by donb - 2010-12-01 11:12:13

Hi Teresa, I want to thank you for your update on our comments. It's this type of communication between members which keeps our group alive, good solid info for myself also as I may find a time for lead removal. I'm almost 80 and my mother lived till 101, so who knows, I may live long enough for laser removal. Remember how fortunate to have these new ways of dealing with our blood plumbing system. Hopefully you will get some positive feedback from members which have had the procedure with success. Please post another request for comments on Laser lead removal from members who have had it, it's not that uncommon!!! donb

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