Can a PM shift?

Just put in a couple of posts earlier today on my doubts and fears. Then looked at this forum and find that there are others sharing my predicament. From the various Qs I gather that the basic Q any of us needs to address is : "Is it at all possible for a PM to shift after implantation, and if so under what circumstances? Same Q for the leads"

Strikes me we are all groping around in the dark on this basic issue. I would suggest we all ask our docs this basic Q, and pool the answers. Unless, of course, there is already some collective wisdom on the web-site on this aspect, and maybe some expert medical advice.

What say, shall we try and get answers within the week, and see where it leaves us reg different types of exercises.
K.Gopal Rao

6 Comments

shifting

by Tracey_E - 2013-04-27 04:04:14

Theoretically they are stitched into place but sometimes they are not so they shift, sometimes they are stitched but shift anyway. The leads are almost always too long. Instead of cutting them to the right length, they coil the extra and place it behind the device which means if the device shifts, your leads have plenty of slack so it's not going to stress them.

If it shifts to a point where it's uncomfortable or starts to come through the skin (rare!! usually from infection more than just shifting) then they can revise the pocket. Normally they'd just watch it for 6 months to a year to see how it settles before deciding to revise.

We tend to get the same questions from newbies over and over! Some of it is drs not explaining well, other times it's just that it's so overwhelming that everything they tell you doesn't sink in. On some subjects, such as exercise, there are no standard answers, ask 10 drs and get 10 different replies. There are so few of us who are active and otherwise healthy, pacing among the young has mostly only happened in the last 20 years. Most drs don't have more than one or two patients like us and there are no large studies, no long term evidence. We are the guinea pigs, so to speak, the next generation will have much more information by looking at us and how we fared. OTOH, I don't mind being the guinea pig. If I'd been born the same year as my mom, I would not have seen my 30th birthday so it's all good.

Shifting Pacemaker

by donb - 2013-04-27 10:04:04

Hi, Well Tracey pretty well covered your question. I'm 7 years older than you and am on my 5th pacemaker since 1992. As I'm a skinny very active person I've managed to have 2 PMs' move , my 3rd unit was just under my skin & it moved & eroded after about 3years of implant. MY replacement 4th PM was put on my right chest under my muscle which was really comfortable. Unfortunately my mind is stronger than my body & I did some heavy work reaching up high. Next thing I knew my PM pushed from under the muscle towards my armpit & got swollen. As Tracey mentioned another surgery was in order to do a revision & replace with my 5th PM back into it's under muscle site.
I have never really gotten a true answer from my 2 differant Cardiologists as Why? My wife, a retired Cardiac nurse tells me to just plain "cool it" as I still am as active at age 81 as I was at age 60. She may be right !! Strange though as I woke up one morning with my last PM under my armpit & was sleeping along.
DonB

Sorry!!

by donb - 2013-04-27 10:04:12

Bad Typo !! Was "sleeping alone"

PM Shifting

by Grateful Heart - 2013-04-28 11:04:37

My shifts towards my underarm sometimes. Also with certain exercises on machines. It gets uncomfortable at times. Not working as hard as donb though.

Grateful Heart

Response to TraceyE/donb re PM movement

by kgopalrao - 2013-05-03 01:05:57

Hi TraceyE/donb, & Grateful Heart,
Thanks for all the info. Not very reassuring, tho’, if PMs are sometimes not stitched securely thro’ oversight, and, therefore, move. I wonder whether donb’s 2 cases of shifting were such, or even come under PMs which were securely stitched and still moved. I don’t suppose, don, that they gave u any indication. Makes me wonder. Here I live in a 3rd world country, viz. India, and 3 other docs apart from the one who did the job have assured me that they have NO cases of a PM shifting, and certainly none of a PM not being secured as it should be. Seems weird to me. I presume u 3 are all either from the UK or US, and we generally assume that the norms are much more stringently observed there. Could it be that the sheer volme of PM implants, as compared to India, has bred an element of complacency in the procedure? On the basis of my discussions heer, it seems that cases of a PM shifting are certainly rare, and I have to assume that securing the PM has been properly done, and in such circumstances it will not shift.

Coming to the effect of exercise, as Tracey says theer are as many opinions as doctors. My queries were specifically about exercises involving the pectorals (pushups, jumping jacks, wts with shoulder presses and chest flys). Two said go ahead rgrdless, only no contact sports, two said they do not have enough data to say go ahead, and if, God forbid, theer should be a PM shift due to my exercises, that would not be very clever! So it looks to me as tho’ here the docs are divided between ‘cant shift and go ahead regardles’, and the second ‘cant shift but we don’t know what vigorous exercise will do’.

That leaves us, as Tracey says, as the guinea pigs. But do tell us, donb, what is the kind of activity which resulted in yr 2 shifts, and u Grateful Heart. Is it specific exercises of the kind I listed above, or just vigorous activity of whatever kind (dancing, kitchen work, housework)? And Tracey, u seem to be a bit of an expert. Professional or lay(wo)man? You hv given me a synopsis of what often happens, w/o referring to yr own experiences reg shifting, if any? Could u elaborate?

Meanwhile, folks, I intend to go ahead with pushups etc, familial pressure notwithstanding, till someone with experience screams at me to stop. Could be one of you. Just did a full workout today after a long time and did it feel good. The trouble with this PM bit at our age – meaning donb and me – is that it’s a thin dividing line between too much exercise and not enough, and with not enough I’m sure those of us geriatrics used to it will soon be going down the drain. Do lets continue to exchange views.
Cheers. Gopal Rao

shifting pm

by jimsplans@yahoo.com - 2013-05-05 05:05:52

Yeah they can and the leads can pull loose for the first month is what I was told when they did mine 3 weeks ago hence why you r not suposed to lift your arm to high or cary over a gallon of milk the scar tissue will grow around it in that time and lock the icd and leads in place.

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