Possible Lead Change - New location?

I have hit ERT and am scheduling my replacement. This will be my fourth replacement since I got my initial PM in 1993. My original PM was made by a company that is no longer in business and the PM and leads were proprietary to them only so the leads (still implanted since '93) are useless. My current leads are located on the right side of my chest and have been in place since 1998.

The surgeon has told me that he thinks there may be a possibility that he will have to put new leads in since my active ones are nearly 15 years old.

He has said he may have to look at my lower abdomen for a location for the implant. Has anyone else had this done?

12 Comments

my twin

by Tracey_E - 2013-08-16 01:08:32

I'll be 47 in a few weeks, looks like we got them about the same time. I'm in south Florida. Jackson Memorial is outstanding.

Too bad the dude who invented extraction (blanking on his name) retired a few years ago, he was in FLL.

Name

by Gellia3 - 2013-08-16 03:08:07

I think the name you are looking for is Charles Byrd, MD. He worked on the Excimer Lasar Sheath and was probably in at least the top two or three in the country using it. I nearly went to him in 2001 for extraction but elected to leave a dropped and looped wire alone.

It sounds like you are in the right place.
GOOD LUCK!

Best to you,
Gellia

Gellia

by Tracey_E - 2013-08-16 04:08:06

That's who I was thinking of, Dr. Byrd!

an fyi, LilyaM, when one of mine was bad we did a venogram, just an iv with dye in the cath lab, to see if I had room for another lead. I wanted to know where we were going before surgery so I could take my time making a decision. I had room for one more so it was an easy decision. If it hadn't fit, I would have had to decide between moving location and extracting.

extraction?

by Tracey_E - 2013-08-16 07:08:17

First of all, do they have an indication the leads are bad?? They always test them when they do the replacement, but they can tell from the reports if the leads aren't working well. Just because the average life of a lead is 15 years doesn't mean they can't last a whole lot longer than that. We have members with working leads 30+ years old. I got my first pm in 1994 and still use one of my original leads. If it ain't broke, don't fix it!

Depending on your age, I would probably go with extraction over moving to the abdomen, take out that first set and put it back on the left if you can. That's much more common than moving to a third location, if you are a candidate.

Or, if only one lead is bad, you can usually fit a third one on top of the other two. That's what we did when one of my original leads went bad, capped it off and added a new one so now I have 3.

Moving to the abdomen can work well, as it has for Don, but it's considered a last resort when you've exhausted your other options.

Everyone - Thanks for the Info!!

by LilyaM - 2013-08-16 07:08:19

It does not appear that there is anything wrong with my leads. All of my scans have come in normal. It is just something that came up when were were discussing the replant and it was the first time I had heard the possibility of having the generator and leads in the abdomen as opposed to either the right or left side of my chest.

I have learned a great deal of information from this forum (which until I started noodling around last night did not know about) and will be seeking more information from my doctor before we go for the replant. I am supposed to have the surgery in the next 2-3 weeks so I will be updating everyone shortly.

Where was the internet 20 years ago when I was a very scared 28 year old mother of a toddler with a brand spanking new PM, no warning I was getting one and not a clue what it did? LOL

BTW, as my 5 and 7 year old nephews are very fond of saying - You guys ROCK!

Response to New Location & Extraction

by LilyaM - 2013-08-16 10:08:33

DonB - Thanks for the information.

TraceyE - I am only 48, I got my first implant when I was 28 due to Wolff-Parkinson-White and an electrical ablation procedure that resulted in the 100% block of my upper AV node. The leads have not been tested yet, the doctor has only notified me that this MAY be a possibility since my leads have been in for such a long time.

I live in Florida and Jackson Memorial in Miami has an excellent history of extracting leads successfully if it were to come to that.

In re-reading my posting, I knew what I wanted to say, but it came across wrong. He did not say that an abdominal placement was his only option, just one option that he may have to consider and I was looking for more information.

Thanks for the insight!

Hi

by Gellia3 - 2013-08-16 11:08:50

I agree with TraceyE. They normally test the leads before thinking of replacing them.

I have had the same leads since 1982. They are still working well and my EP has seen no reason to change things. As he puts it, "If it ain't broke, don't fix it".

It just a thought.

Whatever you decide, please come back and let us know.
We that have increasingly aging wires are very interested.

Thanks so much and my best to you,
Gellia

Lead Extraction

by donb - 2013-08-16 12:08:11

Hi, I just want to add that lead extraction in my case was considered but not possible with a normal lazer procedure. As my Cardiologist had a Plastic Surgeon do my left site restoration years ago he chose to tension my leads where they entered the vein and then proceeded to cut the leads allowing them to retract. Open heart would have been an option but also has risks.
As I knew this Dr. Lieberman to be not only National but also International Pacemaker expert doing Forums around the world, I had full confidence in his planned procedure.
I also want to add with all the many procedures of 6 pacemakers, site restorations that my present abdominal implant under muscle is completely painless & the 1st time in 21 years I have complete rest, roll from side to side while sleeping. I also have no limitations of any activities which is bad in my case as I've always abused my body doing heavy work. I want to also add that my abdominal implant is not the same as was done years back. As Dr. Lieberman has published books & is well known for his work.
DonB

Yes!

by jeanlancour - 2013-08-16 12:08:39

I am sure you will be hearing from some of them, I have seen it here, you might try the search, type in lead replacement, and see what comes up. Good luck. Jean

New Location !!

by donb - 2013-08-16 12:08:58

Hi, Reading your post is exactly where I was at a few months ago. After using up both left & right chest sites with 2 leads initial implant in 1992 & another 2 leads with my 4th implant in my right chest in 2009. Unfortunately erosion took it's toll & I ended with lead infection pocket &
heart wall.
Harper University Hospital c/o Dr. Randy Lieberman did my lead & pacemaker removal in June, put me on a 7week Vancomycin IV program, and did my implant & leads in July using my right abdomin & groin routing leads up my artery to my heart. As I had to have my antibiotic administered at a care facility I was released to return home this July 25th.
Now, I'm doing great, BUT, I was also optimistic with my 1st right chest under muscle implant & posted how great & comfortable it was. Only 3 years after another erosion resulting another replacement implant only to erode this past March.
As I'm "only" 81 years old but way too active with a skinny body has been a natural for traveling pacemaker. I do have a little fat around my waist at belt level so I'm hosting a VERY comfortable pacemaker but also have resorted to some nice "Larry King" suspenders. Hopefully this pacemaker, my 6th will enjoy it's home. I also have to mention also that my original pair of leads from 1992 could not be removed & a TEE showed slight trace infection also which resulted in the extensive Vancomycin IV program for treatment. I really should be Thankfull as I had a top specialist do my surgeries as I mentioned above. You might google his name & hospital in Detroit, MI as he has an excellant site. Thank You !!
Donb

amen to that!

by Tracey_E - 2013-08-17 09:08:09

I would have given about anything for a place like this when I got my first one also! The first time I ever met anyone with a similar situation to mine was 5 years ago through here.

Replant Done

by LilyaM - 2013-09-06 09:09:33

I got my replacement/replant done yesterday, My leads are fine and my doctor feels that there should not be any problem with them for the next 8-10 years.

I am still a bit sore at the incision site, but that is to be expected.

Thanks everyone for all the thoughts, comments and encouragement.

Lilya

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