Cooked Spaghetti?

A website says PM leads are the size of cooked spaghetti. Wow. Without restricting normal blood flow in the veins?

Is the lead "screwed in" to the outside of the atrial, as someone told me? Are any attached to the inside of the heart? How?

It is difficult to imagine a doctor turning one end the spaghetti - even if it is stiff- so that after 30 inches of twists and turns it firmly attaches the other end to a muscle.

Is there a website that describes the mechanics of pacer implants?

My three month old pm is doing its job and my next appointment is in six months - so these questions are to satisfy my curiousity.





2 Comments

Lead placement

by golden_snitch - 2014-08-15 02:08:57

Hi!

The veins have a larger volume than you would probably imagine. And the leads are getting thinner and thinner. They usually only start restricting blood flow in a vein when there are three to five leads in the vein, but of course in some patients one lead alone already causes problems - everyone is different.

There are different types of electrode tips. You can have "active" or "passive" fixation. The screw in lead is an active fixation, a passive fixation lead had a little kind of "hook" at the tip. Choice of the leads depends on preference by your doctor, but active fixation leads are used more often (lower rates of dislodgement). Leads are in the vast majority of cases attached inside of the heart; if you place the lead through a vein, you always end up inside the heart. Leads are placed with the help of an "introducer" and a "guidewire". There is a description of the procedure at:
http://emedicine.medscape.com/article/1839735-technique#aw2aab6b4b2

In a few cases, especially in small children, pacemaker leads are placed outside of the heart (epicardial leads). This is a much more invasive procedure as you have to open the chest and the pericardium.

Inga

Thanks, Inga

by azviking - 2014-08-15 11:08:03

Thanks for the explanation and reference to the website..

Threading several leads and a guide wire through the vein and attaching them to different parts of the heart is a technological marvel and a godsend to me and to other pacers.

My first experience with them was in 1960 when an 80 year old uncle got a pacemaker. He was up and about quickly and I was told that he made medical headlines. The process has likely advanced significantly since then. When told that I needed one I did not hesitate.

azviking

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