Lead displacement

• by aman73
• 2012-07-21 04:07:59
• Batteries & Leads
• 2848 views
• 5 comments

Hi!

Firstly I would like to thank whoever has put together this forum wherein everyone associated/connected (directly/indirectly or thru a Lead!)to a cardio-verter. It is quite informative.

I'm 38, Rheaumatoid Arthritis patient since 1996, morbidly obese (appx 230Lbs) , HTN since 2008. Yep, Bio's quite impressive.

Was diagnosed with an InfraHisian 2:1 AV block in my pumping station. Got a dual chamber MRI compatible pacemaker (Biotronik) implanted on the 12th July 2012.

Things went of well. Since my left side had some veins blocked, it was implanted on the right side with 2 leads. One going on the top atrium, another in the bottom Ventricle. 14th July, upon checking the parameters etc, some readings were wrong and upon checking under the flourascent machine in the OT, docs (and me!) Came to know that the top lead has displaced and fallen down. Well all hell broke loose. N since I was still in the hosp, doc performed another surgery and after a no of rounds of making me cough hard n breath heavy on the OT, they fixed it. Btw, I'm told since I'm overwght, they have used leads with screws and not hooks. ( This has now changed - since leads with hooks are not MRI compatible, they have used screw ones!).

Everything was ok. I was again checked on the 16th and let off.

Yesterday I again visited for my review and when readings were taken- Boom! Again the same thing has happened. The top lead has fallen down. Bottom one going to the ventricle is ok.

The explanation is a mix of the lead being heavy due to the screw as well as hook one not MRI compatible.

Well they have reprogrammed my device to work as single chamber , giving impulse to the bottom lead to the ventricle. They say that since my own hearts pacing is 70 at the moment , the single lead / single chamber setting is doing the main part- sensing and pacing the heart upon a fall (below 40 BPM), I may not need a dual chamber function. They would want to monitor. But yes the fallen lead will have to be surgically dealt with.

Options ( in order of best-last) given to me n my questions/concerns to my fellow forum members:

1. Take out the fallen lead and run my device on one lead only. As a Single chamber giving assistance to the ventricle.

Q: then why was I installed with a costly dual chamber? Wot if I actually need a dual chamber PM?

2. Take out the lead and implant a new one.

Q: won't that fall off? Yeah I'm sure it would.

3. Take the lead out and explore putting a hooked one. MRI thing can be worked out. Maybe will have to avoid MRi in future.

Q: I paid appx 70K INR more for the MRI compatible. Since I'm an RA patient, never know when I may need an MRI.

4. Go under the Surgeons knife who will rip my chest apart n then implant in my heart - this surely is not a good idea as per the cardio's. And I agree.


As per them, the verdict is that the Atriel lead (top lead) in a dual chamber PM did not work for me.

People, what do you suggest. And is it sounding like a good up? I've been very careful about immobilization etc. From my side , after getting slit twice and spending hours on that table with my RA, I've been really careful. So leads fall off like this? Is it that I'm unfortunate OR a victim of medical negligence? Do I take a second opinion or just follow wot my current life saviors are saying? Its one of the prestigious hospitals here in india with senior cardios.

Thanks and await comments.

Love you all,

An Indian with a american accent , who loves British underground music and with a german second heart.