Rv lead problems

Hi,

I have a biventricular pacemaker and have been feeling dizzy, faint and just generally odd for quite a while. I went to A & E to be told I probably had an inner ear infection ( but that's another story !!) since the. I have been for my 6 monthly pm check to find out my RV lead is faulty - I'm unsure why Pm was only implanted dec 2011.

I have been informed I will have the lead replaced sometime in the next month - my question is how much damage am I doing to my heart whilst I wait for this correction, I was 99% dependent on pm previously. I also have an additional problem as in I am waiting for surgery on my ascending aortic aneurysm ( end of Jan expected op date), I'm concerned that the extra pressure from the RV not working properly will put more pressure on my heart and aneurysm.

Any advice greatly received.

Thanks

3 Comments

CRT

by golden_snitch - 2014-12-04 01:12:53

Hi!

I have been paced on the left side (left atrium, left ventricle) for more than two years now, and my heart is functioning perfectly. I'm paced 100% in the atria and ventricles.

If you have a bi-ventricular pacemaker (CRT), and the right ventricular lead is faulty, this is in my opinion nothing that needs immediate attention. As long as the left ventricle is being paced, you should be okay. This is the lead that matters most.

In some patients right ventricular pacing only leads to the right and left ventricle beating out of sync. This leads to inefficient pumping of the left ventricle, and since the left ventricle is the one pumping the oxygen rich blood to the whole body, you get symptoms of heart failure. Now, if the left ventricle is stimulated, it will work fine/pump efficiently. And the stimulus from the left ventricular lead will makes its way to the right ventricle. So, your right ventricle still works well.

My EPs said that in the beginning of CRTs it was tested whether one really needed to stimulate both ventricles. It was found out that just pacing the left ventricle has the same effect as pacing both ventricles. But since most patients with CRTs had a dual chamber pacemaker before, and therefore already have a right ventricular lead, they get bi-ventricular devices. And other patients gets CRT-Ds with a defibrillator, and the defib lead is always placed in the right ventricle.

An interesting link: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1501093/

Inga

RV leads

by Grateful Heart - 2014-12-05 04:12:14


I have a CRT-D and had a RV lead problem. It had to be replaced too. Sometimes they move/ shift and start stimulating your diaphragm. I waited over a month for my revision. (The waiting was the hardest).

In my case, this CRT-D is my first device and the defib lead is indeed in the right ventricle like Inga said.

Good luck on your upcoming surgeries.

Grateful Heart

Leads

by Peppurr - 2014-12-08 04:12:19

Hi, I have a duel Pacemaker, and a medical person told me that the leads are almost impossible to fix if broken, and most Doctors won't even try. This has scared me to no end. What do you know about that? Thank you and God bless.

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