Arrrggghhh - Pacemaker Lead Detachment

[Johnny Stephens]

So I got this shiny new pacemaker on the 19th - the procedure went well (exept for the part where my heart stopped on the table) and I was healing up nicely. I only missed 2 days of work.

About 4 days afterward, I began to notice weird palpitations and severe lack of cardiac reserve (starting to walk too quickly would bring me up short for a few seconds). A couple of calls to the Heart Center and I was told to come in for an "adjustment". While the techs were downloading the data, I started to hear lots of "hmmmm" and "that's strange" over my shoulder--not what you wanna hear in a cardiology office.

Long story short, the atrial lead has become detached from the heart wall and fallen down into the right ventricle. Apparently this happens in a small percentage of cases. My usually supportive wife got on me about this, and as much as said it's my fault for not paying attention to the postop motion restrictions and being too "active."

I get to go in Tuesday morning at 6:30 AM to have the lead "revised." At least I won't have to have the whole cardiac catheterization part that is done prior to the original implant, they just work from the chest incision (which is only about 2" long).

Enough already.

 

[Ross]

Sometimes you just feel like a piece of meat.

 

[hensylee]

Sometimes you ARE a piece of meat.

 

[Kathleen]

Sorry

Sorry

Sorry to hear this happened. I got an InSync in Oct 04. When you mentioned they will fix the lead with the 2 inch chest incision did you have the pacer implanted with that same incision? Is the pacer in the shoulder area or the rib area? I am asking since I will be having a fourth attempt to abalte the AV node which is behind my mechanical mitral valve which is on the left side where it is not supposed to be. They will use a mini thoracotomy approach. Just trying to get some thoughts on the invasiveness of this approach and how you felt.
Enough is enough total agreement from me.
Kathy

 

[Johnny Stephens]

Hi Kathy, yes, the pacemaker was inserted into a "pocket" they created under the skin through the 2" incision. The placement is about 1/2" below the collarbone on the left side. I can actually feel it under the skin It was not very invasive at all - in fact they closed the incision with Durabond adhesive (no stitches).

 

[Marguerite53]

interesting read

interesting read

Johnny. Thanks for sharing! It is very useful to know all the angles and possibilties. Keeps things real when people like me are in this rotating waiting room. I hope they get you wired up properly. Being told that your heart stopped on the table and then having to deal with the hmmmms and oh my's doesnt' sound like any fun at all!! You seem to be in excellent sprits despite it all.

Do you think your wife was right? Did you overdo it? Or maybe they need to be scolded for not designing a more flexible connection .

Good luck. Marguerite

 

[Kathleen]

Placement

Placement

Mine is in the same place as yours. My EP is going to give me a call this week so I will ask him about the incision he will make for me this time. I wonder why they would not do the lead replacement using a groin incision rather than the pacer site. I have been told I am little so my pacer really stands out which stops me from moving in certain directions. We may have to implant and ICD on the other shoulder if we cannot ablate the AV node. I hope you plan a few more days of time off after this lead is placed. I was in the hospital for 5 days after impant. Rather think each day in the hospital requires one week for recovery. Small analogy I have worked out after all this convoluted medical history I have amassed.
Kathy

 

[bvdr]

Sorry, Johnny. Hopefully everything will smooth out again for you once this is over. Take it slow after this "adjustment". A wife sometimes has a very clear picture of what is going on..... .

 

[gadgetman]

Johnny ,

Another word you do not want to hear----"Ooooops!!!"

Sorry to hear you are experiencing some problems. After they implanted my AICD it was discovered that the impedance on the lead had gone up. After examination they determined that the probe did not "set" properly. As I was going to have OHS they decided to "relocate" the lead while in there . Seems like everything is OK now.

Hope they get everything straight real soon. I also have a "shoulder mate" and was glued back together. Wow, ain't medical science wonderful!!!!!

 

[Nan]

Hi Johnny, sorry you are having to go through all of this! Enough already! Hopefully this will be fixed and that will be that. It sure is scary to have things go wrong. Fortunately this can be repaired.
Good Luck!

 

[ALCapshaw2]

I hate to say this Johnny, but I was really concerned about your being allowed to drive immediately following implantation of your pacemaker.

Remember the accquaintance I mentioned who was NOT allowed to drive for 6 weeks following his pacemaker implantation? He even had his left arm in a sling for that period. Chalk up one for the Alabama Cardiologists!

Hope your reattachment goes well.

And PLEASE, take it easy for a few weeks, especially with regard to range of motion of the arm on the same side as your pacemaker.

I need to keep my Radiation / Valve Replacement Role Model around for inspiration!

'AL Capshaw'

 

[Nancy]

Johnny-

I'm sorry to hear this. Just when things were improving. I swear, the more you mess around with the body, the more messing around has to be done.

I hope it's an easy procedure. I'll be thinking about you.

 

[Johnny Stephens]

Good to go

Good to go

I had the lead reattached on Tuesday morning, and all went well during the procedure. The original implantation on the 19th took 2 1/2 hours, including the EP study (the part that stopped my heart).

The anesthetic injection into the still-tender implantation site was exquisitely painful. Other than that, smooth sailing, and I'm again all wired-up. The Guidant rep was actually part of the team that scrubbed up for the surgery, and he did some electrical tests on the spot that confirmed the placement of the lead.

I asked the Doc point blank if the lead detachment was due to something I did - he said he really doubted it. He said the the original implantation site can often be scarred by previous OHS, and he has seen them fall out from there before. In most people that site works well, and the lead tends to naturally curve and align to that spot.

I tried to go to work yesterday, and managed to get a few hours in before my boss "discovered" me. He sent me home until Monday, so today I get to sit around and play with Photoshop

 

[Mary]

I had the lead reattached on Tuesday morning, and all went well during the procedure. The original implantation on the 19th took 2 1/2 hours, including the EP study (the part that stopped my heart).

The anesthetic injection into the still-tender implantation site was exquisitely painful. Other than that, smooth sailing, and I'm again all wired-up. The Guidant rep was actually part of the team that scrubbed up for the surgery, and he did some electrical tests on the spot that confirmed the placement of the lead.

I asked the Doc point blank if the lead detachment was due to something I did - he said he really doubted it. He said the the original implantation site can often be scarred by previous OHS, and he has seen them fall out from there before. In most people that site works well, and the lead tends to naturally curve and align to that spot.

I tried to go to work yesterday, and managed to get a few hours in before my boss "discovered" me. He sent me home until Monday, so today I get to sit around and play with Photoshop

It's good to know you're doing fine after the latest procedure. I hope this ends all your problems for a long, long time!
Mary

 

[ALCapshaw2]

Once again, we learn that being a heart patient "isn't for sissies"

Classic understatement from Johnny Stephens:

"The anesthetic injection into the still-tender implantation site was exquisitely painful. "

AH, the joys of heart procedures!

Glad to hear that all turned out well for you Johnny.

Best wishes for a boring recovery.

'AL Capshaw'