Pacemaker v Alien

So I have had a problem with my PM for the past few months. It started as a small bruise, but has developed and it is quite obvious that the box is migrating its way to the surface of my skin. I can only imagine the end result a scene similar to Alien.

Anyway, I saw my Electrocardiology and he was disturbed. He says it sometimes happens (I obviously missed the mention of pacemakers rupturing out of the body in the small print). He said it is because the site was infected with endocarditis. I underwent treatment for Endocarditis two years ago, and went from a state of sepsis and a life expectancy of days to leaving 9 weeks later after making a decent recovery. I left on oral Fluclox as the Gen and Vanc destroyed my veins and couldn’t be used for the full course. My infected box and wires couldn’t be replaced due to poor venous access. I am on Flucox to date.

Anyway. I have a few questions.

1) Are escaping pacemakers really a known hazard?
2) After 4 pacemakers (all sited in right clavicle and all leads down same vein) how the hell are new veins found/repaired/salvaged in order to do something? I surely can’t be the only pacemaker patient who needs a new box and has limited venous access?

There is talk of open heart stuff, but surely that requires MORE veins! and the ability to sustain bypass?

The good point is I am clinically well, with only minimal extra symptoms (edema being the main one). And my circulatory system has had 2 years to recover from EC and the IV Gent & Vanc.

But yea, occluded vein game plans and vindictive pacemakers I’d like to know about.

Thanks for your time and help

7 Comments

Hi:)

by Pookie - 2011-08-23 10:08:29

I have been a member here for over 6 yrs now (oh my gosh, where does the time go??) and I've read several posts quite similar to yours in the fact of having leads replaced and the question has been raised on how the heck will they get more leads in there. I often had that thought in my head as well.

And the answer is Yes to a pacemaker being able to migrate....mine decided to take up residency in my armpit and I had surgery to reposition it; a few others have had their pacer start to come to the surface of the skin - this is where it becomes tricky & dangerous because of infection.

I do hope your doctors are keeping a close eye on you.

The best place to get some of your answers or some advice is by using the "search" feature - upper right hand corner of this screen - there you will find oodles of information posted by other members.

The past few weeks has been very quiet on here, so don't think anyone is ignoring your post, I just think it's everyone out enjoying Summer before it's over:)

Take care,
Pookie

PM relocation

by Heidiglassmeyer - 2011-08-23 11:08:30

I was fortunate to bring the concern to my EP when I noticed my PM had become very close to the surface, the scar was eroding and was ready to "break through". He explained that it could cause an infection, as you know, is very dangerous and if that occured the box and leads would need to be moved to the other side of my chest. I was immediately scheduled for a relocation sub-muscular.

I am not familiar with the condition you describe with your veins but I guess if it was an option for them to replace and re-wire on the left (you said all had been on your right) they would do that? Are all your veins damaged? I'm not "up" on the hearts anatomy, don't know if they go through the same veins regardless of the side your box is placed.

As Pookie said, we have had several members describe their PM moving. If you use the search function you may even find posts from members who have had an issue with their veins such as yourself.

Welcome & hope you get some answers :)
Heidi

Veins

by Clodester - 2011-08-24 08:08:48

My pacemaker hasn't been relocated to the left side because I am told that the veins are occluded.

I have veins suitable for short term drips but, in terms of more major veins, for pacemakers, central lines etc, apparently these are gold dust according to my EP. However I have recently made friends with a Vascular surgeon who seemed confident that there was hope. He felt happy that there would be decent usable veins deeper. My EP didn't share his confidence as he said that the surgeon wasnt aware of all the information. However in the decade iv been having pacemakers, not once has a vascular expert seen me. So I hope a vascular point of view will come up with answers.

My pacemakers (4) have been put in by 2 Drs. 2 with my former DR (a pediatric cardiologist) and the last 2 with my current EP.

Im amazed moving boxes is as common as it is. But I feel no pain, nor am I 'sick'. I am simply conscious of the fact that the available veins are few and the need is great.

Thank you all for you help though

PM Erosion

by donb - 2011-08-24 10:08:46

Hi, You're postings of PM not enjoying site location brings me lots of "pucker" feelings as I've had relocation of my 4th PM to right chest. You might want to do a Search on my postings as I joined up 2 years ago after being a happy PM patient 17 years prior. I do share your feelings of concern as being only 23 years of age. My worries of future PM replacements & leads should be minimum as I will be 80 next January although my mother lived to age 101.

As I've had 2 Cardiologists for my replacements, I have been fortunate with all implants. I also share you're having a good Vascular surgeon to work with your EP Cardiologist. You have my support!! Good Luck. donb

Just have to say this

by ElectricFrank - 2011-08-24 12:08:13

Answer to Q1: I've never been attacked by an escaping pacemaker.

Serious thoughts on your situation. Were all 4 pacemakers implanted by the same surgeon? Their could be an answer there.

You didn't mention any attempts at using a left side placement. If it hasn't been tried, why not?

And finally, the cardiologist that did my original implant and then a replacement last year always precedes the surgery with a 15 minute drip of one of the more powerful antibiotics. He then follows up with a second infusion 4 hours later and after the surgery. I live in a relatively small town and have not heard of anyone having infection problems.

You could also be one of the few who have an allergy to the pacer or leads.

best wishes,

frank

Thanks

by ElectricFrank - 2011-08-25 01:08:53

Thanks for updating me on your situation. I realize that there are situations where things are about as good as they are going to get. You seem to have a good grasp and are working with it.

best wishes,

frank

Waters have broken

by Clodester - 2011-09-22 11:09:20

My 'Waters have broken!' as it were. The PM finally broke through my skin last night. I had/still have a dressing over it. I noticed that there was yellow fluid absorbed in the dressed. I went to my GP this morning and he took a swab and redressed it. The fluid I am guessing is serum. There's no blood, no redness or soreness. So I wouldn't expect it to be pus or infection. A small bruise directly on the wound, the small 3 mm big hole which has appeared. Im not freaking out, i am worried by the fact that i cant feel anything. The device which is keeping me alive, which has a pocket/ localised infection is now through my skin.

My EC is concerned, as am I and infection is the main time limit. I just wanted to know what do I do now? I have obv called my EC, my Cardiac team, my GP knows etc etc. So in terms of medical intervention for now...until I am admitted for surgery etc, they can do very little. What do I do? leave it? bath it? disinfect daily? or leave it? Help and advice is basically what im after. Obv nobody in my local town has seen this or can give advice...so anything would be great, thanks!

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