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Medronic Viva XT CRT-D Issues
Hello, is there anyone else out there who's received the Medtronic Viva XT CRT-D? This is my fifth device, 2nd CRT-D, and my first "lead revision."
The lead revision was necessary because that tricky LV lead was not previously placed in an optimal spot, due to vessels being too small to allow the cath tip down into the vessel as far as they wanted. The result was that it zapped the battery at only two years because it took more energy to capture that left ventricle.
I am a HUGE FAN of Medtronic, and I credit the CRT-D with saving my life, after losing both my sister and brother to dilated cardiomyopathy way before they should have died. I'm 53 now, and have managed to not only survive heart failure, but it's now been 10 years since my initial diagnosis, and last echo showed my EF has gone from 25% to 45% as of last year.
Now that I've blah-blah'ed you to death, I'll ask my question! :)
The new CRT-D I have is supposed to be thinner and more rounded than my last one, which was the Protecta XT. It doesn't look smaller from the outside, and now that it's been in there for six weeks, I'm seeing little bumps that protrude where none did before, as if there were two grapes sitting on top of the device. It already looked a bit scary with the bump and the three parallel scars from other surgeries, now it just looks weird. If it's the price I must pay for better therapy, so be it. I just wonder if anyone else is seeing this irregular profile in the dimpling of the skin covering their CRT-D. Please let me know. (Mine is not under the muscle, I'm a fairly slight guy, so it's just under the skin and therefore quite obvious. The other issue I have is phrenic nerve stimulation, something I've never had before. They were able to get this newer, smaller lead much deeper down to the distal part of my LV, and while it gives vastly improved conductivity for dual chamber pacing, it now sits right next to that phrenic nerve, so I've been awakened multiple times now by my left diaphragm being paced. It's like being jabbed in the side with a pool cue. Stops when I change position, but it hits me again at odd times, especially when I yawn or stretch. Had one adjustment to the device so far, hoping they can tweak it further with polarity adjustments and maybe even a bit less voltage to the LV as long as that doesn't compromise capture of the LV pacing threshold.
Thoughts? Comments? I love you guys, and thanks for always being here to support and educate me. Happy Mother's Day to all you Moms out there!! :)
Sincerely,
Marty
3 Comments
Hi
by Katelyn - 2014-05-15 03:05:39
Im 27 and have a CRT-D (Protecta), mine is under the skin... I dont have any bumps (this is my 4th device, I had 3 ICDs and then this is my first CRT). Keep an eye on it to make sure its just scarring and not infection...
I had phrenic nerve stim the first couple weeks with my new LV lead, but after several setting adjustments we got rid of it. If possible, keep getting it adjusted, you really shouldnt have to live with the stim.
Katelyn
by Marty - 2014-05-15 07:05:34
Hi Katelyn,
Just happened to be on right when you posted a comment to my concerns about the bumps. Thanks for weighing in, we have similar timelines and that was a good point about watching for infection. I did have it checked and the Medtronic rep said no worries, just the shape of the device against my skin. My EP doc was great about letting me choose any device I wanted each of the last three implant times, and I did all the same reading I bet you did to choose Medtronic. This Viva XT may well be your next CRT, hopefully years from now, but it's impressive, with the adaptive pacing and vastly improved battery life.
Anyway, I'm so sorry to see you've already been through a bunch with this cardiac disorder business. I previously had two Medtronic ICDs, started in 2004, then got the Protecta XT, and now Medtronic's newest marvel, the Viva XT. I'm curious where you were EF-wise when you got your CRT-D? Why did you require intervention at such a young age? Congenital heart block? After I got the last CRT (Protecta), my EF went from 25% - 45% in less than two years, heart size returned to normal, and I got to go back to 99% of my previous activities, including racquetball.
My only daughter's name is Katelynn, so you quickly got my attention, in fact, we almost spelled her name just like yours, but finally went with the two n's at the end. :) She's 23 and so far, only some episodic tachycardia, but she married a Marine and is constantly exercising and in excellent shape, so I hope she doesn't ever develop my heart issues.
Again, appreciate your thoughts, and hope you wear out another 10 of these things!
Marty
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by Mywingman - 2014-05-08 03:05:27
Hi Marty,
I have the Medtronic A3DR01 on March 19th. It is a double lead unit because of my 2nd degree type II heart block. I am on my 7th week with my little friend. I am 57. I am thin too. Mine is just under the skin on the left shoulder. I can feel it under the skin. The only bumps I feel are near where the leads connect to the unit. I am all healed up and feeling great. Hope this helps.
Victor