Dr. coverup? Lead displacement

Here is some background:

- I had arrhythmia with a 2nd degree block. Low cholesterol. not overweight, I've been in great physical condition other than this.

- On 21 April 2014 I had a pacemaker put into my RIGHT side as I am left handed. We wanted the device on my non-dominant shooting arm. The following were implanted:

Medtronic SureScan Pacemaker A2DR01
Leads were: 5086MRI52
5086MRI45

- I kept my arm in the sling nearly the entire time and didn't do anything like lifting my elbow over my shoulder.
- 7 days later 28 APR 2014, I woke up feeling great. In the afternoon, I took a nap. Got up, stretched my back then started to immediately feel bad, run down, and really tired. Like I felt before my pacemaker was put in.

29 APR 2014. I went in to my cardiologist and they did a check on my pacemaker with the monitor. Something indicated to them that the top lead was not in it's correct position. An X-Ray had indicated that the lead had displaced and just hanging in my heart. The device manufacturer rep was present and got a little stiff lipped inside the dr's office. Out in the parking lot he told me that a longer lead should have been used for the right side insertion. A longer lead was required since the right side insertion because a longer distance from the pacemaker to the heart. I don't remember his exact words as I was feeling pretty bad at the time, both from the displaced lead and from the prospect of having to undergo another surgery so soon from my first experience.

30 April 2014:
I go under for surgery. The Dr. told me that he re-inserted the lead, but that he had KEPT THE SAME LEAD in place.

Saturday, I get a 2nd Medical Device Identification card from the manufacturer (device), and it stated a different implant date and different serial number that indicated a longer lead had been put into place. New implant date (30 APR 2014), and a different serial number (5086MRI52, instead of the original 5086MRI45) had been implanted. The last 2 numbers off the lead serial number indicated that a different length lead had been implanted (52 cm instead of the 45 cm lead)

I did some research and found that lead displacement occurrences happened only in around 3% of all pacemakers

1) Does a right side implantation necessarily requires a longer lead?
2) Did the Dr. make an oversight in the implantation by putting in a shorter lead into a right side implantation?
3) Did I fall into the category of bad luck of the unlucky 3% of pacemakers that have a lead displacement?

I hate to think I went through a 2nd surgery due to an oversight.


3 Comments

leads

by Terry - 2014-05-12 01:05:02

Do you want a manufacturer's Rep who is willing to risk his relationship with the doctor by being candid with you? I think I would respect the Rep for that. Too often the medical/industrial complex is not at the best interest of the patient, as it was decades ago. See PacemakerPatientAdvocacy.com.

leads

by Tracey_E - 2014-05-12 09:05:54

It is a longer reach from the right side but as far as I know, they can use the same leads for left or right side. There is usually plenty of slack, they coil the extra and place it behind the device.

It is normal to try to reposition the same lead if it doesn't stay put the first time. If it comes loose a second time, they will often try a different type of lead.

Leads come displaced from poor placement, sometimes the heart wall isn't cooperative, sometimes the shape of the heart makes it hard to find a good spot, but more often than not it's just bad luck and no ones fault. If you think about it, it's amazing they ever get a lead in place the first try. They are doing it remotely, watching via x-ray, and the heart is beating and moving the whole time.

JMHO but it was hugely unprofessional to tell you something off the record in the parking lot, esp something negative against your dr. True or not, I would not have a lot of faith in someone who would do that. That said, it's suspicious he'd say he kept the old lead when you got a new serial number. That pretty much screams new lead.

Using the sling 24/7 after the first day is a mistake. Your shoulder can freeze. It's important to move the arm normally, just don't lift or raise it too high.

leads

by wjs1954 - 2014-05-12 11:05:40

just checked my card, my PM is on the left side

last two numbers are 52 for one 58 for the other.

same PM as yours, and i am a medium sized guy... not sure what that has to do with anything, probably nothing at all.....

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