Clavicle Crush

My pacemaker technician mentioned the possibility that I am experiencing a "clavicle crush."  Has anybody ever heard this term before?  I can’t find much research on this topic. Would appreciate some feedback.

She said that my clavicle is putting pressure on my top lead wire and causing the wire "insulation" to pull and weaken, effecting my pacer settings. She switched my settings from bipolar to unipolar and says she thinks this will make a difference in the pacer performance. The trouble is, I don’t really know what all this means!
Any help would be great!!

3 Comments

insulation

by Tracey_E - 2008-11-20 10:11:18

Well, I've never heard of clavicle crush and I'm not sure what bipolar and unipolar is, but I've had a rupture in the insulation in one of my leads for several years now. It still works just fine, but they have the voltage turned way up to get the signal through. Picture an open refrigerator- it still cools but the power bill is higher. My battery life is shortened because of it. I chose not to replace it when I had my last battery done. Battery replacements are really easy, I'd rather do them more often than mess with the leads if I don't have to.

clavicle crush is.

by turboz24 - 2008-11-20 10:11:32

clavicle crush is when your upper rib and clavicle come really close together and possibly pinch the wire as it feeds from the area on your chest, through your chest muscle, into the vein located under your collar bone (clavicle). The routing of the wire can be done in such a way to avoid that issue.

Lead Problem

by ElectricFrank - 2008-11-21 02:11:45

The change to unipolar is only a workaround for a serious problem. If the insulation has been breached (which is the only reason it would affect the pacemaker settings) it would seem to be only a matter of time until the lead was further damaged by the crush and pacing would fail. The effect of this depends on how dependent you are on the the pacer.
The other potential problem is that the current leaking into the surrounding tissue can over time produce irritation and/or twitching of the muscle in the area.

You didn't mention how long you have had the pacemaker. If it has only been a short time then lead removal and replacement should be fairly easy. After time though it becomes more encapsulated by the vein wall which makes removal a more difficult and risky procedure. Sometimes they just leave the old lead in place and run a new one.

The bottom line is that you really should get a second opinion. Keep in mind that most insurance companies and Medicare pay a fixed fee for the implant. If a problem develops due to the way the leads were routed the surgeon would be required to do the followup as part of the job. This doesn't lead to an objective opinion of what needs to be done. If they can put you off long enough the "warranty" expires.

I wish I had better news!

frank

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