Lead Fractures & Replacements

My first pacemaker was back in 1983 and I have had 4 pacemaker replacements since then and I'm due for another replacement in about 1-1/2 years. I also am having problems with my ventricular lead. I have had 2 lead fractures in the past, thus there are 4 leads presently in my heart. Dr. says I will have to have the laser lead extraction since they don't want to put anymore in and I'm 56 years of age and will probably have future lead problems. Has anyone had the laser lead extraction and how difficult was it for leads that are almost 27 years old? Also, how long does the procedure take if they have to take out 3 leads. They also reset the ventricular lead that is having problems to a unipolar lead instead of bipolar until I have the surgery. Now I am getting really bad muscle twitching in my left chest and arm. Very annoying during the day and dificult to sleep at night. I have not set up the surgery yet because I am also dealing with some other health issues and want to finish the testing on these other issues before the lead extraction. Any opinions or comments would be welcomed.

9 Comments

Leads!

by tcrabtree85 - 2010-07-26 01:07:14

First I have to thank you it is very encouraging to know that a pm can last so long. All 3 of mine so far have not lasted long b/c of complications.
I have had my leads taken out twice but the longest they were left in was for a year in half. I developed a lot of scar tissue which made it a little more challenging. I had no problems and it wasn't horrible. I know they say it's dangerous having your leads taken out and is scary at times to think about. I had no problems with the removal of either set.
I think with the way the technology is now that they will have no problems getting yours out either. Ask as many questions as you need too is all I recommend. Has your dr experienced working with leads placed in so long? What is the likely hood for bleeding. Those are the type of questions I asked and it really calmed my nerves knowing that my Dr had so much experience with the removal leads.
I wish you luck. If you have any questions please feel free to send me a private message.

Blessings,
Tammy

Leads

by Goldens - 2010-07-26 03:07:34


Tammy:

Thanks for your response. I was 28 when I had my first pacemaker back in 1983 and it lasted 2 years and since then have had 3 other pacemaker battery replacements and will need another one in about a year. My heart condtion is brady tachy syndrome with episodes of complete heart block. The average length of the other batteries that I have had have been about 6-7 years. Since that time I have also had 2 lead fractures. One for the atrium and one for the ventricle. They had capped both of those off and kept them in. Now that I am having trouble with my ventricular lead - they said I will need the laser extraction to try to get all the caped off leads out to make room for the new wire. I have been reading about the procedure and seems like there is more risk when the leads have been in for a long time due to all the adhesions and scar tissue build up around the lead. I have also had in the past an ablation; one of my wires looped into the tricuspid valve putting me into heart failure and then I have also had surgery to reposition the pacemaker due to slippage of the unit. So you can see I am a veteran of pacemakers. Just a little concerned about the lead extraction with wires that have been in for so long. Your questions to ask the doctor are excellent. I also need to find out how many procedures he has done and what type of complications he has encountered. I am a little nervous about the procedure.

My other concern right now is the twitching and chest and arm spasms I am experiencing at the present time since the set the ventricular lead to a unipolar mode instead of bipolar mode until I have the surgery. This is very uncomfortable and annoying and not sure how long I can handle this. However, I need to follow up on some other tests for other health issues I am having before the lead extraction. Do you know anything about someone having the muscle twitching in the left chest and left arm?

Thanks for your comments and if you know anyone who has had the laser lead extraction when leads have been in for such a long time - I would appreciate any type of communication.
Nancy

unipolar setting and lead extraction

by ladybug - 2010-07-27 12:07:50

When my pm was set on unipolar prior to my lead extraction, I had severe shoulder twitching. My cardio didn't want that so changed it back. I also had 8 hour laser lead extraction with wires that were 8 years old. It was complicated! I feel very lucky because I also had a ton of scar tissue. Wires can be difflicult to easy to remove. It all depends on how much scar tissue. My Denver cardio wont even remove wires if over 12 years....he sends you to the best....Cleveland Clinic!!
Ladybug

Lead Fractures

by Goldens - 2010-09-08 01:09:06

Lead life can vary and there are various things that can alter the life of the lead. My fractures have generally been insulation problems. I have been told that lead life is approx 16 years, but with new technology that may be improving. My first leads were inserted in 1983 and one was replaced in 1994 and1997. This new lead that was just inserted 2010 replaced the 1994 lead. I also am on my 5th pacemaker. Battery life depends upon how much you use your pacemaker. The more you use it, the frequent it needs to be changed.

Hopefully, my 1997 lead won't get a fracture in it too soon. We had complications with my recent surgery and they took out one lead with the laser sheath - but were unable to get out the other 2 leads due to complications during surgery. My left subclavian vein is 100% occluded due to all the adhesions & wires - so I really don't know what the next direction will be when the 1997 lead goes bad. Hopefully I have answered your concern.

St Jude ICD leads

by relax221 - 2010-09-08 12:09:59

I've had 2 pacemakers . The first 2000 and the second 2005 . My battery is at 2.52 and will replace at 2.45. When and how often do they replace the leads ? I've never been shocked. Any help ? Mike

Sepi1956

by Sepi1956 - 2011-12-08 01:12:11

Hi Everyone.
I have had an AV ablation and therefore I am pacemaker dependant. The past few days I have experienced bubble like feelings just below my eight breast almost to the centre of my chest. Could this be a lead fracture? Please help as I am in a real spin about this.

lead fractures

by Goldens - 2012-03-20 10:03:00

from what I have been told - leads should last approx 16 years. When they put your last lead in - didn't they try to extract any of the old leads? You need to make sure you go to a specialist that deals with lead extraction and your cardiologist should be an electrophysiologist who specializes in rhythm disorders. Unfortunately, some leads will never be able to be extracted because of the length of time they have been in and all the scar tissue. Cleveland Clinic is suppose to be the expert on lead extractions. Your lead does sound like a product malfunction if they just put it in last year. I really don't have any good advice except to seek out the experts and see what they might be able to do for you. Good Luck

Lead failure

by CB4 - 2012-03-20 12:03:35

Hey,
So I'm 20 years old and am on my 4th Medtronic Pacemaker. I was born with a complete heart block and had my first one implanted at 5 years old. I've never really had any problems other than needing replacement pacemakers. I have 4 leads in the same vein due to having to get new leads when my pacemaker had to be moved from the left side of my chest to right because of too much scar tissue to put the new one at the time on the left. A year ago I got my second pacemaker on the right side which have had the same leads for 8 or 9 years and one is now showing ventricular warning and needs to be replaced. My cardothoracic surgeon won't put a 5th lead in since it can cause blood clots which would "make my head explode" The Medtronic people tried to switch it from bipolar to unipolar to buy us more time but I instantly balled and couldn't tolerate it pounding so hard. It felt like my pacemaker was going to fly out of my chest. I go back in a couple days to another surgeon about doing the laser extraction of the faulty lead and replacing it with a new one. Are there any questions I need to ask? Also, is it a product malfunction that the lead messed up or something the surgeon did on my surgery a year ago? I don't understand how something that is supposed to be lifetime just randomly almost exactly a year after surgery fails when everything was checked during surgery.

lead fractures

by jaydole - 2013-04-27 10:04:51

I have had my ICD for 2 years and I just got it replaced for the first time last week for a lead fracture. My surgery to replace my ICD and use the laser strategy to extract the lead was 9 hours long!

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