How can you tell if a lead has issues?

Hi everyone,

I have an old lead which is the lead responsible for all the pacing - I am not pacer dependant in the other chamber.

It is 18 years old and my doctor thinks I should leave it next change which could be in 6 months.

Every time I exercise in the past 2 weeks I have been feeling a twinge - or pull under the pacer - the leads I suspect are above that (site was on top of breast area).

I would love to hear from others:

1. With old leads - can they really last?
2. Experiencing any symptoms like mine from exercise or the like
3. Negative or problematic lead replacement
4. Positive or negative extraction

Thanks so much

Cat

7 Comments

leads

by Tracey_E - 2010-01-26 09:01:12

Hi Cat!
They can tell if a lead is working when they do your checks. Theoretically leads can last forever. As long as it's working, I'd leave it alone.

I have a lead that went bad 6 or 7 years ago. It worked but it drained the battery quickly because the insulation was fractured. When I had my last change, I chose to keep the bad lead and live with a short battery life. It got worse in the last year so I had it replaced yesterday when I got my newest battery. It was very easy to add the new one and we did not extract the bad one, just capped it off and left it in there.

We only have so much space in there for leads. I intend to be pacing for many years to come, so I wanted to wait as long as possible before adding more hardware in there.

thanks

by montrealgirl - 2010-01-26 10:01:28

Very encouraging words. Mine has been at the same level now 240-250 since I got my last one in 2003... I don't know where the danger zone is but I will ask on Thursday.

Hope you recover fast :)

Cat

20 years, easy

by pacemaker writer - 2010-01-27 07:01:33

Hi,
When I worked for pacemaker manufacturers, we often heard of leads that had been iworking fine for 20 years ... that was nothing remarkable. So I think they can theoretically last forever.

They check your leads every time you go in for a check-up. If the leads are not working, it shows up on the programmer.

One of the big things they look for (but not the only thing, certainly) is lead impedance, which is an electrical measurement of resistance. Lead impedance fluctuates normally but if it fluctuates suddenly by a large amount, it suggests something is up with the lead. Most programmers automatically monitor lead impedance and alert the physician if something seems not right.

Other signs that the lead is damaged occur when the pacemaker isn't pacing or sensing correctly or if the battery is being drained too quickly. I think most docs are pretty vigilant in looking for these things when you come in for a check-up.

Hi Cat,

by Gellia2 - 2010-01-27 08:01:27

I do believe that Tracey is correct in that, theoretically, a lead can last forever. I sure hope so because I've had both my working (I also have one that is not working and capped off) leads that were placed back in 1982.

My EP says that if they work to leave them alone and so far, so good. I did have the ventricle wire snap at the pacemaker connection but that was an easy repair (I swear they used duct tape - LOL) and the lead remained.
They are now 29 years old.

It's a good age!

Hope this helps some,
Gellia

Hi again,

by Gellia2 - 2010-01-27 10:01:07

Both my 29 year old leads are functioning well. The impedance has gone up slightly on the atrial wire but with 3rd degree block, my V- wire is the critical one and it works fine.

It's also the one that broke. I actually flipped over in bed and snapped it. When I had had my last replacement (I've had pacers since 1975) the wires were coiled under my collarbone funny. It caused a subclavian crush injury that just snapped it. I felt a sharp knife like pain and got symptoms that were like the ones that I got my pacer for in the first place. It was easy for me to tell right away.

That was 2001 and the wire got a connector and is still very much in use and working fine.

Thankfully, both my wires are fine, so far, but I do wonder if they will last my lifetime. I'll cross that bridge, if and when it comes.

I do think I'll keep mine for alot longer though. :)

Gellia

Wow!

by montrealgirl - 2010-01-27 12:01:14

So are any of the 29 year old leads functional? How did you know it snapped? What did that feel like?

thanks for the answer :)

Cat

thanks for all the information

by montrealgirl - 2010-01-31 09:01:53

I feel a lot more confident about things. My appointment to get checked was postponed until February. I adjusted my exercise routine from 5 to 3 days until then and will keep my fingers crossed.

Have a great week.

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