Lead and pacemaker replacement

Hi everybody!
I think this is the fist time I post a message. I've read many, but never posted one. I think I need to rise up to the occacion since I'll have my pacemaker and my upper atrial lead replaced next Monday. I must say I'm scared and stressed. In the past few weeks I felt terribly tired and suddently my pacemaker alarm started going off practically everyday. I saw two Meditronic guys on three different times until the last one told me there was something wrong with my lead. I will have surgery perfromed my electrophisiologist Dr. Alberto Lopez from Houston Texas.
I'm only 25 and I based on that I think that more than likely my doctor is going to decide to extract the old lead (since 1997) and replace it with a new one. I've heard many things about this kind of surgery and it makes me uneasy to know the risks. I just pray that God looks over me through the process and for HIM to guide the doctors' hands. I just keep thinking about my little boy and how I wished there was a miraculous procedure that would make me healthy. I pray for it every day.
Anyways, I just wanted to vent and to ask if any of you have the same congenital hear disease I have. I have not met anybody my age, other than small children. Also, does anybody know what I can expect on the day of surgery and afterwards for recovery??
I want to stay possitive and I have left this whole thing in God's hands. I will come back to update you after surgery.
Monday.... here I come!!

7 Comments

spelling errors

by AndyMota - 2012-04-20 04:04:03

Sorry for the horrible spelling... it's 2:30 a.m. and I'm in zombie mode as I'm unable to go to sleep :(

Lead removal

by golden_snitch - 2012-04-20 06:04:32

Hi Andy,

if your cardio hasn't mentioned removing the old lead, yet, I'd not jump to the conclusion that because of your age, he'll most likely take the broken lead out. If you, to date, have only two pacer leads in there might very well be enough room for a third lead. And since that old lead has been in place for 15 years I'd expect that it only gets removed if there really, really is no other choice.

I totally understand that you are worried. But like a friend of mine often says about uncertain things: Let's worry about it when time comes. For now you don't know for sure that you need a lead removal. And your age alone does not indicate what is likely to happen. Usually, lead removals are done in patients who already have several leads in. Since removal is a little bit more risky, doctors do it only, if there really is no room for another lead. So, if there is no removal, your up-coming surgery will be like the one you had 1997. If you are very nervous and scared, ask about sedation. Most doctors are willing to give you something to relax or even sleep while they puts the pacer in.

By the way, I don't have congenital heart disease, but got my first pacer when I was 18. Also had open-heart surgery when I was 22.

Good luck & all the best

Inga

God Helps those who hep themselves!

by donr - 2012-04-20 09:04:14

Andy: My lead in says it all! Why do you just rely on God to take care of you? He loaned you intelligence, strength & knowledge. He depends on you to do a certain amount of the leg work.

F'rinstance - WHY haven't you come right out & asked your EP what he plans to do? It's your right! You owe it to yourself & your family. While you are zonked out is not a time to be totally at the mercy & whim of your EP, no matter how good he/she is!

You need to discuss in excruciating detail EXACTLY what he plans to do & what his options are once he gets in there & faces a decision because he suddenly comes upon an unknown unknown factor. You need to know exactly what all the possibilities are & voice YOUR decisions as to what he is to do IF he suddenly stumbles on one of them. If he doesn't disclose them or does not want to talk to you about the subject - RUN like a bat out of a belfry that catches fire. He is not a good surgeon, no matter what your current thoughts are. The most important thing to him is his own ego, not your well-being.

I do not have the serious heart probems you have, but faced the exact same problem w/ a broken lead. I had this discussion w/my EP. I went into the surgery fully informed about the possibilities. Believe it or not - EXTRACTIION was NOT one of them! Why? Because he did not do extractions - He did not consider himself qualified. I wound up w/a third lead in the same vein - as opposed to having my PM switched to the other side.

Below is a comment I posted for someone else to read - w/a link that you must copy & paste. The link takes you to a site that discusses in detail al the ins & outs of lead extraction. You owe it to everyone to read & heed before you wander into this procedure.

Don


Begin cut & paste:

"Want to read a scholarly article on this?

Comment posted by donr on 2012-03-17 23:40.

Haven't had one(Lead extraction), but stumbled on an article in Google a week or so ago about it.

Listed the URL below - you'll have to copy & past it to get there.

Lead extraction is NOT a trivial procedure. Takes a lot of skill to perform it successfully. Any hack can do it unsuccessfully. A lot of skill & continual practice, like many other complex procedures.

Below is the comment I posted w/ the link. Enjoy.

Don
Want to read a scholarly work on this?
Comment posted by donr on 2012-03-10 09:50.
Last night, after reading at least three posts on lead extraction questions, I went to Google & found this PDF format document by the Heart Rhythm Society. All sorts of interesting info in it. Like what are the conditions for removing old leads. Criteria for a surgeon to be adequately trained & experienced in lead extraction. Mortality rates for the procedure (under 1% for an "Experienced" surgeon). It's a 45 page document, well written & truly interesting - IF you are a PM Host facing a potential lead extraction. recommendations on what type institution you should go to for the procedure.

http://www.hrsonline.org/news/media/press-releases/upload/leadextraction_cieds.pdf"

End cut & paste


Great advice

by Heidiglassmeyer - 2012-04-20 10:04:47

Hey Andy, great advice above. Arm yourself with information. Maybe you can make some calls to find out exactly what the plan is during surgery. As a fellow Houstonian I know we have several excellent hospitals in the medical center and a wide range of talented doctors at our fingertips. If you will in fact having a lead removal hopefully you've had a chance to find out how many removals your EP has completed and maybe even get a second opinion if a lead removal would be necessary. Not saying your EP isn't the right one but no harm by looking a little further into this. I have not personally had a lead removed but have enough information to know it's not as easy as just placing a new lead.
I would think your recovery will be very similar to your original implant unless there is an extraction done.
Can't stress enough, be prepared. Personally I'm getting ready for major back surgery on Wednesday and have a list of questions to ask my neurosurgeon on Monday during my pre-op appointment. Having surgery is scary but for me, faith in God and information are two powers I rely on the most:)
I wish you the best next week!
Heidi

Lead Extraction

by bjbumblebee - 2012-04-21 12:04:24

I just had 3 leads extracted on March 8, 2012. For what it's worth, the surgery was a success and I feel better than I have had for over 5 years. I stayed over night in the hospital and my home recovery was the same as when I have a generator change (which I also had at the time of the extractions). The important thing is that the lead extraction be done by a team of experts who do them regularly!!!!

Also, if you only have 2 leads in place, currently working and not working, then you should have room for a 3rd lead. A 4th lead gets to be a bit much.

Talk to your doctor, they should know before they even schedule the surgery as to what they are going to do. You don't want your doctor going in and then deciding to do an extraction if he is not an expert of extractions!

Best wishes to you.

Bonnie

Thanks!

by AndyMota - 2012-04-22 04:04:36

Thank you everyone for your input. I really appreciate the advice. Don, you are absolutely right: "God helps those who help themselves". To tell you the truth all my life I've opted for not knowing, partially because I was scared to know the gravity of my situation... and because I was a child at time I got my first two pacemakers. But now the situation has changed, I have a family I need to care for and not getting enough information is definitely irresponsible from my part. My wife is the one that has taken it upon her to do research on everything related to my disease, surgeries, etc. I've even told her once that looking into the subject too much was only going to make her worry more. I'm just petrified. During the last two weeks, the whole process of getting in contact with my doctors in Houston and having the surgery scheduled happened so fast that I really did not get a chance to have a conversation with my doctor. I do not live in Houston, so my visits were limited to once a year. I'll make sure to go over all the information you guys suggested with my doctor on Monday. I was told the doctor wants to change the battery on my pacemaker (I just found out today that only the battery will be changed) and replace the lead by the nurse in charge of scheduling the surgeries for my doctor's office. I asked the nurse how long I will be required to stay at the hospital and she said only one day, does that sound reasonable to you? I'm planning on staying in Houston an extra couple of days, just to make sure that my recovery is going well and that I do not have to go back to the hospital. As you can tell, I have not done a good job at obtaining more information. I need to get over my fears and just face the music. After all, uncertainty only makes me more uneasy. I did some research about the doctor and apparently he has been named one of the top ten doctors in Texas for numerous consecutive years. I found the following info, but was not able to find patients who have had their leads replaced by him. Here is his info:

Practicing Since 1984
Training
Good Samaritan Hospital, University of Cincinnati, Cincinnati, OH
Mayo Clinic, Rochester, MN
Baylor College of Medicine / Texas Heart Institute, Houston, TX
University of Miami, Miami, FL
Certifications
American Board of Internal Medicine
Board Certified in Internal Medicine, Cardiovascular Disease, Clinical Cardiac Electrophysiology and Critical Care Medicine
Honors
Associate Professor of Medicine, Baylor College of Medicine
Cardiology and Electrophysiology Teaching Staff, Baylor College of Medicine and St. Luke’s Episcopal Hospital/Texas Heart Institute
Special Interests
Consultative and Interventional Electrophysiology (Cardiac catheter ablation for Atrial Flutter, Atrial Fibrillation, SVT and VT)
Pacing and arrhythmia management (Pacemakers and Defibrillators)
Cardiac Resynchronization for congestive heart failure
He looks pretty well qualified on paper. I’ll keep you posted on how my surgery went.
Don, once again, thank you for the info and for calling me out… I think I needed that.

God for you:

by donr - 2012-04-24 12:04:25

Andy: sorry I did not acknowledge your note sooner - just saw it tonight. bonnie (Bumblebee) had some good words for you in reporting her lead extraction.

The only thing you did not learn from the on line vetting of your surgeon is how many he does in a year.
When you see him...ASK!

My #2 daughter just walked in & I told her of your situatioin. She'san ER Doc. Said that some peoplr handle situations like this the wa you do - by shunning info & just being scared. We had a minor difference of opinion. You have a great wife if she does the research for you. That can help tremendously if she doew the stressful scut work & just gives you the bottom line. Sounds like she can handle that nicely.

As a side bar - I had an associate who was diagnosed w cancer back in 1996. His wife did all the dirty research for him & found some dr's who were on the cutting edge of treating his kind of cancer. She got him an extra 16 SIXTEEN years, when he was given THREE MONTHS originally. He just turned 40. That's what a good helpmate can do for you. Just remember that when she gets in trouble.

The absolute best to you in this procedure. Glad I was able to help.

Don

You know you're wired when...

Friends call you the bionic man.

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My pacemaker has ultimately saved mine and my unborn child’s life for which I am thankful.