Using all three leads

I haven't posted in quite a while. I had a CRT-D implanted January 31st this year. Just a little over 6 months. I am monitored at night by St. Joseph and they do a down load every 91 days. It was a hard sugery for me as the device is pretty big and I chose to have it placed underneath my muscle so it would not show. I am small so getting the opening big enough was a challenge for the surgeon. There is a bump or mound there but no one would notice. I am just now getting back to normal, what ever that is. My shoulder bothers me at times and the car seat belt still hurts. I am sure in time that will go away. I am not complaining as I feel lucky to have my new life jacket.

I went to the surgeon two weeks ago and they made a small adjustment to the left lead located inside my heart. (I have a left bundle block, enlarged heart and cardiomyopathy . Before surgery my ejection was 30 but started out at 22 before meds. It went up to 35-40 but went down to 30 prior to the ICD). I saw my cardiologist yesterday. The EKG showed I was spiking and the third lead was being used. I thought two of the leads where for the resnychronization and the third was for the difibulator if I needed it. So I got home and started thinking which sometimes can be dangerous and think my heart is worse by needing that third lead. On a side note the doc said had I not had the ICD implanted when I did I would have been in clinical heart failure within Two years. What does that "Clinical" mean? Is there just regular heart failure?

Please let me know what you think.
Thank
Texas 54

5 Comments

Clinical Heart Failure

by IAN MC - 2013-08-08 02:08:04

Hi Texas Doctors love putting the word " clinical" in front of various medical conditions and there is nothing to be overly concerned by it ..

There can be many causes of heart failure ( which doesn't mean that your heart is going to suddenly stop, it just means that it is not pumping as well as it should ) eg alcohol, cocaine or chemotherapy can cause it but that would not be "clinical" heart failure.

Drs use the word "clinical" when the condition has certain well-known symptoms and history , i.e. it is fairly typical in it's cause and presentation. In the case of heart failure this may mean that the heart doesn't pump properly because the blood flow is inadequate because of narrowing of the coronary arteries.

This is my understanding , I know that one of our members , Selwyn, is medically-qualified and if he is reading this his explanation of the word "clinical" in this context would be helpful.

Perhaps someone will expand on the exact role of your 3rd lead.

Best wishes

Ian

We have a lot in common!

by Acin - 2013-08-08 02:08:27

I don't know what clinical means but I too have Cardiomyopathy and a Left Bundle Branch Block. When I was diagnosed in March of this year, my EF was 20. After being on meds for 3 months it went up to 30. I have a an ICD; got it July 16th and I feel a lot better.

I'm somone w/lots of knowledge can address the "clinical" term. Take care!

Hi Texas

by ebfox - 2013-08-08 03:08:57

I remember you very well, prior to your surgery you asked about implanting under the skin or under the muscle.
Calling it your "new life jacket" is a good way to think about it.
Regarding your questions:

-on most ICD's the third lead is used for pacing the bottom of the heart. For you, that is probably due to your left bundle block. The device tried to atrially pace you, that got blocked, so the device paces your ventricle.

Regarding "Clinical"- a physician friend of mine says that most likely the doctor means that you would "meet the definition of heart failure." The broad definition of heart failure is "when the heart is unable to provide sufficient pump action to maintain blood flow to meet the needs of the body." Heart failure can be caused by a bunch of different things; your doctor was telling you that the ICD corrected what was potentially a life threatening situation (at least that is my take on it).

It is good to hear from you and I hope you continue to feel better- sometimes healing is slow,.

Take Care-

Three leads

by Texas54 - 2013-08-08 04:08:30

These comments are very informative. I see that I should be using all three leads now and the "Clinical" term makes sense to me now.
Thank you very much!

Thanks

by Texas54 - 2013-08-10 05:08:18

Well, thank you for this additional clarification . I should have asked my Doctor but didn't think about it until I got home.

As usual this club has helped me.

You know you're wired when...

You make store alarms beep.

Member Quotes

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!