Biotronix Pacemaker Lead Complication

I just recently received a Biotronix Dual Lead Pacemaker and had an immediate complication with the lower lead to the heart chamber. It read well at time of implant, within a few days the lead had dropped in reading from 10 to 3.5 and we had to redo the surgery a week later to reattach the lead. Again it read a 9 at time of surgery but within less than a week it dropped to 3.4. Now they are considering doing it again. Has anyone out there experienced this? I am losing all faith in the unit and possibly the surgeon. They have it set at 50. But I notice that when my heart rate goes up with any activity I experience the very symptoms I was having before the pacemaker which supposedly helped them determine I needed the pacemaker, complete heart block. I'm confused how does this work to fix that???

4 Comments

Lead Problem

by Jakle - 2012-11-25 02:11:16

I too have a Biotronix but am very pleased with it. I don't believe your problem is anything to do with the unit.

Good luck...

leads

by Tracey_E - 2012-11-25 02:11:38

50 would be the minimum rate, which is pretty much irrelevant with heart block. With block, the sinus node in the atria works fine, the problem is the signal getting to the ventricles. It's unlikely your atrial rate will ever get under 50, which is why the lower limit is irrelevant. The atrial lead mostly just watches. The ventricular lead is there to make sure the ventricles beat whenever the atria does, pacing a beat whenever the ventricles don't do it on their own.

If the ventricular lead is dislodged, it's not surprising that you feel the way you did before the pm, because the ventricles are probably not pacing. Easiest way to tell is count your pulse when you are being active and see if it's up or like it was before.

When a lead isn't in an ideal place, sometimes they can turn it up and get it to work but it sounds like that's not the case. Even if it is the case, it's better to get the lead fixed now because turning it up to get the signal through drains the battery very quickly. My ventricular lead went bad, they were able to turn it up and keep it working short term but the battery only lasted 2 years. In my case it was an old lead that went bad so since they were able to keep it working I waited out the rest of the battery life and fixed both at the same time.

It's hard to say if it's the surgeon, your heart, or just bad luck. I'd at the very least get another opinion before having another surgery with the same team.

Sometimes it's the surgeon. Was it done by an electrophysiologist or a general cardiologist or cardiac surgeon? Ep's are the best choice, they do pm's all day long and are the most capable of dealing with anything out of the ordinary.

Sometimes it's the structure of our heart that makes it tricky to find a good place to put the lead so it's not really the surgeon's fault.

Sometimes it's the heart wall not compatible with the leads. Leads can have barbs or screws to attach, if one isn't working for you it might be time to try the other.

Not sure about the lead problem...

by USMC-Pacer - 2012-11-25 12:11:13

but the other problem is most likely related to the upper rate limit on the PM.. I am dealing with that now, as a matter of fact, I am calling my EP tomorrow to get it raised. It is at 150, yours could be at the default 120... Have you tried taking your pulse as the symptoms start? The PM will only track you to that #, then will put you back into block.. You can Google "Pacemaker Wenckebach" if you like...until someone with more experience than I responds... This is a great site for info. I have only been in it a couple of weeks and have learned TOO much..

response to lead complication

by bamafan - 2012-11-29 10:11:25

I had dual lead pacemaker (medtronics) placed April 2011 and had problems with the lower lead (screw type). I had a re-do with the same lead in June 2011 by a different surgeon/different hospital. Again, the same problem. I had a re-do again in September 2011 with the same surgeon (the 2nd surgeon) but a J-hook lead by Boston Scientific was inserted and the old lead taken out. The third time was a charm. Am over a year out now with no further complications.

Each time when it was discovered that the lower lead was not functioning properly, I experienced the same symptoms as prior to the pacemaker. My surgeon told me it was because the atrial pacer was doing the work for both chambers, and causing things to be out of sinc.

My surgeon told me after he removed the bad lead that it was defective and sent it back to the manufacturer (Medtronic).

I think Tracey E's comments above are the best explanations I have come across in quite a while. It is possible that there are several issues going on at the same time.

Hope you are able to get things straightened out soon! Best of luck to you.

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At age 20, I will be getting a pacemaker in few weeks along with an SA node ablation. This opportunity may change a five year prognosis into a normal life span! I look forward to being a little old lady with a wicked cane!