Fractured Lead LV on Bi-v

Ist message: I found you today, I had my first bi-v implanted in 12/04. The second on 8/31/09. Last one a Boston Scientific (BS). Since 2004 I have had one incident recorded. The communicator next to my bed indicated a problem with one of the leads (LV). An X-ray showed that two the three leads were bent up near the clavicle. The electrophysiologist said that the LV had 3 times the impedance of the other two leads, indicating a probable fracture. He did give me a quantitative number at that time but due to anxiety I lost it. We talked about solutions and he indicated replacing the lead and I more or less agreed. We went out to the appointment desk and he told the clerk to call me the next day with an appt. That came and went without a call. Upon receiving the notes from the appt. His notes acknowledge the fractured lead. His assessment of my condition indicated an ICD and ischemic Cardiomyopathy. ( His PLAN: that I have a bi-v with increased LV Impedance. The impedance is all over the place.) No quantitative description indicating the lead impedance. This is kind of scary. He just came to florida from Wichita, Ks and I am hoping someone knows of him and his reputation.

2 Comments

leads

by Tracey_E - 2011-06-04 05:06:27

Sounds like he got busy and forgot what decision he made by the time he finished his notes. I'd call and ask to speak with him, ask for an explanation. The lead impedance would be in the pm report so he may not write out the details since the printout is usually attached.

When my lead went bad in a similar fashion, they upped the voltage so the signal would still get through, then we waited until the battery needed replaced and fixed everything at once. It was damaged but still working so we decided to wait out the battery.

Variable Impedance

by ElectricFrank - 2011-06-05 02:06:37

This isn't a good sign. If a lead is fractured, but has a stable impedance it may work to compensate by increasing the voltage. An unstable impedance is an indication of an unreliable condition. One thing that will cause this is if the lead has detached from the heart wall and is flopping around inside the chamber. The impedance will change with position.

I would strongly suggest following up on it. One way to get their attention is to firmly request a copy of the last interrogation. This puts them in the position of someone else having a record of the situation in case a problem developed.

good luck,

frank

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