Lead Wire Fractures

I have had both of my original lead wires fracture on me. These wires were part of the original PM insertion back in 2005. Seems these wires should have lasted more than 7 years. Could it be possible I was given (originally) a set of bad wires?

What is the "normal" length of time most of you have experienced with lead wires before having to get replacements?

Thanks much for the feedback.....Ranman

6 Comments

Lead Replacement

by SMITTY - 2011-05-09 02:05:06

Hello Ranman,


I'll start with your first post and try to answer it. I have heard of using a laser to remove :PM leads, It is fairly common with leads that have been in a few years. While the surgery is a delicate one, it is done frequently and apparently the procedure has been perfected to the point it is not risky. You might want to take a look at http://content.onlinejacc.org/cgi/content/full/33/6/1671 or http://www.cts.usc.edu/zglossary-pacemakerleadextractionexcimerlaser.html. I found the second one especially interesting.

As for your second post with the question about both leads having to be replaced, yes I have heard of it, but not often. As I'm sure you know each time we get a PM checkup an impedance test is run on the leads. My guess it theses tests have shown a gradual degradation of your leads. The degration of the impedance lets the Dr know they will have to be replaced sooner than so he is going to do it when you get a new PM.

As for the life of leads, I don't know of a specified life span. I've had mine for 11 years and impedance is still in an acceptable range. There are several reasons the impedance of a lead indicates it is time for a replacement. To name a few that I can think of. The connection of the lead to the PM has gotten bad. The insulation has gotten old and is allowing a leakage of the current flow. There is a deposit build up at the tip of the lead where it connects to the heart.

As for your question about the leads being deflective when implanted. Of course that is always possible but it is one I would put way down my list of possibilities. I would think a defective lead would have shown up before now. My guess and that is all it is, a guess, there is a buildup of deposit, or scar tissue around the tip of leads. Why this happens, I have no idea.

Good luck,

Smitty

Hi Ranman

by Hot Heart - 2011-05-09 03:05:24

I got my pm in 2008 and was told to expect my wires to last approx 12 years. I have seen people in here who have had wires removed successfully.

HH

wires

by thomast - 2011-05-09 04:05:22

Are you aware of the sprint fidilus) probably wrong spelling leads that were recalled due to breaking

Thomas

Had my leads lasered out 3 weeks ago

by iamsrg - 2011-05-09 11:05:08

I just had my 9 year old leads lasered out to get the MRI friendly PM 3 weeks ago and the procedure is definitely not without significant risk. You may want to check with the doctor about leaving the old leads in and just putting new leads in which I think is the more routine way to go about it if the old leads are no longer functioning properly. Unless you are also getting the MRI friendly PM and MUST have the old leads removed, depending on what study you read, there is up to a 1,5% chance of dying and a much higher % chance of significant complication with lead extraction.

I am currently battling a pericardial effusion and pericarditis related to the lead extraction and still feel like crap 3 weeks after the procedure. I had to go back to the OR when one of my leads came undone and get it extracted and re-attached, which is probably why I feel worse. During the lead extraction, itself, I suffered from a 20 minute period of v-tach, then severe hypotension and even a period of no pulse at all. I got to spend almost 4 days in ICU. No fun at all. :(

I'm so glad I do have the MRI friendly PM, but the lead extraction was some serious business and if they can leave those bad leads in you when they put the new ones in, please consider that option. Also, ask your EP doctor if he or she has extracted 1000s of leads. If not, find someone who has. Complications increase exponentially with a lack of experience. Just Google "pacemaker lead extraction with excimer laser" to be really informed about this.

Good luck!

Experience

by iamsrg - 2011-05-10 10:05:18

Yep, definitely lead extraction is not something you want any old cardiologist doing. My EP doctor has some of the most famous patients in the world. My extraction was done at a Washington DC University Hospital with an extremely experienced EP doctor who has now told me unequivocally that was the last set of leads that was being removed from my body--ever. LOL

Just have surgeon with experience do it

by ElectricFrank - 2011-05-10 12:05:04

This is a tricky procedure. It seems to be reasonably safe when done by an experienced surgeon and facility. Ideally somewhere like the Cleveland Clinic would be my choice. An experienced cardiologist may very well decide they don't have to come out for that matter. I think there is a test to determine how much space is left in the vein.

frank

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