Pacemaker lead dislodged during surgery.

[camgough]

i everyone, I have another question. After my first surgery I needed a pacemaker and had a dual lead Medtronic inserted for heart block. This means there is a lead going into the ventricle and atrium.

After my recent surgery they tested my pacemaker and it showed the atrium lead needed more power to do the job and suggested I follow-up at my local hospital. I had he follow-up yesterday and learned that the lead was likely dislodged or damaged during the AVR and required replacement. The first option will to try and reattach the atrium lead, if it can't be done they will trey and remove it and put a new lead in. If the lead can't be removed they will just cap it and keep it under my skin, then add a new lead.

This is a less serious procedure, but still has some substantial risks, especially with being on coumadin now.

I was not happy with this as it means more painkillers, incision care and arm restrictions for 6 weeks.

Anyone else have this happen during an AVR, or have experience with pacemaker lead re-insertions?

I felt my good recovery was too good to be true!

 

[epstns]

Cam - Sorry to hear of the new electrical issues. We always think "fixed is fixed" but sometimes things get broken when other things are being fixed.

I'm still on my first pacemaker and leads, so I have no direct experience with lead repair or removal.

I don't remember, but are you a member at Pacemaker Club? You might get more responses there, as that site specializes in pacemakers and ICD's.

 

[ottagal]

Cam,

Sorry to hear about this news and unexpected procedure. Hope it is goes smoothly and that you have a quick recovery from this as well.

Steve made a great suggestion about checking out the Pacemaker Club.

Wishing you all the best,

 

[cldlhd]

Sorry to hear about the pacemaker issues hopefully the fix will go smooth, I'm sure it's easy for nm to say but on the bright side having it done now while still in recovery mode May be better than going thru it a year from now. I thought some of the electrical issues from surgery requiring a pacemaker eventually clear up on their own?

 

[camgough]

Thanks everyone,

My electrical heart issues are both very simple and very complex, and has kept the EP doctors on their toes. I have heart block that comes and goes, but the most ideal settings for this (Medtronic - managed ventricle pacing) don't work well for me because |I have a longer than average delay. As a result I'm paced more than I need to be, but this allows me to work out at a higher heart rate (up to 203 bpm).

Sometimes after surgeries the electrical conduction can change as the heart heals or reshapes, but I'm not counting on that now.

I am a member of the pacemaker club site, and there is always some good info.

On a completely other note, what ever happened to cardiacathletes website? It seems non-existent anymore and I can't see any info??

 

[ottagal]

Thanks everyone,


On a completely other note, what ever happened to cardiacathletes website? It seems non-existent anymore and I can't see any info??

Here is the cardiac athletes uk forum:
http://www.cardiacathletes.org.uk/forums/.

 

[epstns]

Cam - I've been thinking over the weekend about your situation. (Yeah - thinking could be dangerous. . . ) Maybe we should pin this topic, as there are a number of valvers here who also have pacemakers, and we should probably start collecting info and experience data so that when/if one of us needs a re-op, we will have some idea of the impact that may have on our pacemakers.

I don't remember that there are many members on Pacemaker Club who also have had valves replaced, so vr may be the place to try to gather the info.

 

[camgough]

Sounds good to me !

 

[rufus]

Hi Cam

I have a biventricular pacemaker (as well as AVR dec 2007 and surgery due 14th April on my ascending and arch aneursym) I had my pm check up last November when I was advised that my RV lead had been dislodged. They decided to fix the lead before my aneursym surgery.

I am unsure of your age , build etc but I'm a 5'4 female, smallish build, 43yrs. I thought they were going to cap of the lead and just insert a new one however due to my age and build they wanted to remove the lead as they were concerned about 'space' in later years for further leads if required. I had original pm procedure 2011 so there was scar tissue which required a 'laser tool' to cut through the scar tissue. The procedure was done under general anethstetic but I still managed to go home the next morning. The bruising was a bit excessive compared to the original procedure but otherwise ok - just restricted for 1 week without driving being careful putting arm above head but after that just slightly careful with lifting items until follow up (approx 6 weeks). I am also on warfarin and again no major issue , my surgeon wanted my inr 2.7 and happily operated at this level.

Good luck, it really isn't anything compared to what you've already been through - especially as procedure completed under general rather the local. Keep us updated.

Rufus

 

[camgough]

I am horrible at updating. I met with the pacemaker surgeon instead of having the procedure. After reviewing the tests and discussions he decided that my lead was fine for now and did not need any intervention. This all came about because I got the courage to email him and explain my situation. I am happy with this was very relieved!

 

[cldlhd]

Glad to hear it

 

[epstns]

Sounds good! As long as things are working, it should be OK. If the lead is compromised, it may affect your battery life, but if you're not pacing a lot the effect may be minimal. I know that over time, my pacing percentage has decreased, and they tell me that most of the battery consumption is now driven by the internal computational functions of the pacemaker, rather than by the amount I pace. The one variable they mentioned, though, was that if my heart starts to need higher current to "pulse" then it would affect battery life negatively.

 

[camgough]

Hey Steve,

My atrial lead only senses, and does not provide any pacing. If it needed to pace, then the state of he lead would really hurt the battery life. They were able to program it differently so it can sense properly at lower sensitivity, if that makes sense!

I go back in a couple months to make sure nothing has changed. The EP, Dr. Baranchuk was very impressed that I questioned the initial decision for a lead change, and stressed the importance for us patients to ask questions and be informed/ involved.

 

[epstns]

The EP, Dr. Baranchuk was very impressed that I questioned the initial decision for a lead change, and stressed the importance for us patients to ask questions and be informed/ involved.

Hear, Hear! ! !

We come here to gather the information to be able to challenge the doctors' decisions. The best of the doctors actually encourage these challenges as it keeps them focused on what is really best for the patient. It also allows us, as patients, to develop 100% confidence in the direction taken.

Well done!

 

[ottagal]

Hear, Hear! ! !

We come here to gather the information to be able to challenge the doctors' decisions. The best of the doctors actually encourage these challenges as it keeps them focused on what is really best for the patient. It also allows us, as patients, to develop 100% confidence in the direction taken.

Well done!

I second that !