Steroids

Hi
I had my pacemaker op 5 weeks ago. I was quite breathless and went back to the clinic and was told they thought that the steroid on the end of the lead had failed and i may have to have the op again. They have put me on a course of steroids for 2 weeks and will review again. Has anyone else had this and what was the outcome? They have adjusted the pm for the time being and i think they said they have hired the threshold. that was 1 week ago. Today it feels like my heart is pounding and I can feel every heartbeat, especially when I lie down. Any ideas??? Thank you

2 Comments

Steroids

by SMITTY - 2009-04-21 10:04:23

Hello Allison,

Please don't be offended by what I say here. But based on what you are telling us, you either misunderstood whoever was telling you the part about the steroid on the end of the lead failing or they were handing you a big bunch of bull.

It is true that some leads are what are called "drug eluting" leads and the coating is some form of steroid, but the probability of it failing is virtually impossible. It is possible you are allergic to the steroid, and that is the cause of your SOB, but that doesn't make sense if you have an additional steroid prescribed for two weeks.

Another possibility is that the lead is not properly attached to the heart wall and your pacemaker is not assisting your heart beat because the electrical impulse is not getting to the heart as it should. This would put you in essentially the same condition as you were before you got the PM.

Now my guess is that one of two things has, or is, happening. Your pacemaker and leads were not implanted properly or you are in bad need of someone that knows how to adjust it correctly.

I say give them one more chance to make things right and if that doesn't happen then see another doctor or insist that your pacemaker be checked by a manufacturers representative. There many more doctors implanting pacemakers than there are doctors that know what they are doing when it comes to the electronics of a PM. But it is extremely rare to come across a manafacturers rep that is not thoroughly knowledgeable about their product.

I wish you good lick,

Smitty

Technical explanation

by swetalvora - 2009-04-22 07:04:40

Hi Alison,

1) The Docs have increased the output voltage of your pacemaker because at lower voltage it was not pacing (threshold has increased).

2) The reason for this could be either the lead may have shifted a bit or your heart tissues have excessively fibrosed leading to a 'high voltage setting' requirement for your pacemaker.

3) If the lead is shifted, they may have to take you to operation theatre for 10-15 minutes and open up for doing small adjustment of lead position.

4) But the docs probably believe that your heart tissues have excessively fibrosed. In such a case, "STEROIDS' help in improving the threshold voltage ( so that it can pace at lower voltage also).

Hence they have put you on steroids.

And till that time taht 'STEROIDS' show its effect, they have increased your Voltage setting with the Pacemaker Programmer'.

Do not worry, the pounding will stop if the doc can reduce the voltage setting of your pacemaker.

Please ensure regular followup as per the docs instruction.

Regards,

SWETAL

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