changing from a 2 lead to a 3 lead

Hi everyone, I recently posted because my husband has been having bouts of CHF and several trips to the hospital because of fluid build up in his lungs. A little reminder on background - he has had cardiomyopathy for about 9 years and last Oct. had a Medtronic 2 lead ICD implanted because of v-tach. Now because of the CHF and it seems they are out of options other than a heart transplant our cardio wants us to talk to the EP about changing this one out for a bi-ventricular (3 lead). He is so thin and the one he has hurts him all the time and the 3 lead is 30% bigger. I'm also concerned because his health is so fragile, I'm concerned about infection and many other things. We don't see the EP until 5/16 because she is currently out of the country. I hope we can make it until then without more trips to the ER. From previous appts. with her I get the impression that she is afraid to "mess with him too much" because he is so fragile. Does anyone have any experience with this or thoughts? Smitty?
Thanks for any input you can offer. Kathy



by kathybnc - 2007-05-01 03:05:40

Thanks so much Smitty and Surferman,

Your posts are a real comfort and a help. I know ultimately it will be his decision - after we get all the facts from the EP, but I get kind of frantic and want all the information I can get my hands on. I appreciate so much your prayers - I know that's what's been keeping him going these last few months. I just pray we can keep out of the hospital until 5/16. Take care and thanks for your continued support to everyone here.


No Information

by Suze - 2007-05-01 07:05:53

Since I have nothing to add to what has already been posted and have no knowledge of three/lead devices, I will just let you and your husband know that you both are in my thoughts and prayers.

Your husband is blessed to have you for support. And I agree with Smitty that whatever decision is made it will be the right decision.

Take care,

Biventricular PM

by Surferman - 2007-05-01 12:05:24

Hello Kathy -
Everythink that Smitty has written covers the topic so well. The only thing that I can add is what I have heard from an MD who I greatly respect. He felt that the three lead/biventricular pm was the way when it comes to pms. His reasoning is that the biventricualar expels more blood with each contraction and helps prevent build-up in the lungs with leads to problems associated with CHF. I'm passing this on as something to consider and discuss when you meet with your husband's EP.
You and your husband are in my and other pacers thoughts and prayers. Keep us posted as you work through this difficult time. Surferman


by SMITTY - 2007-05-01 12:05:33

Hi Kathy,

I know some of what you are talking about, but not enough to offer much help I’m afraid. I have read a little on the three lead pacemakers and how having an impulse going to the front and back of the ventricle can improve ejection fraction, or blood flow from the heart. In fact I had one mentioned as a possibility for me one time when I came up with a low E.F. I was not aware that the three lead units were bigger than my two lead unit, but that would be of no concern to me as I’m about as thick as a bull through my chest area. In fact they could probably put a quart size mayonnaise jar in my chest and it would hardly show.

I certainly understand what you are saying about concern of infection and just the general trauma that goes with surgery since your husband is so fragile. I would think the risk of infection would be no greater this time than it was when he got his present PM. Also, since the doctor is apparently very much aware of your husband’s condition, I’m sure she would be taking all the precautions possible. But when it is all said and done, I guess (and I know this is much easier for me to say than it is for you to do) you and your husband will have to decide which is the greater risk. The short term risk of the new surgery or the long term risk of trying to continue with things as they are now. I will say that whatever you decide it will be the right decision, and don’t ever forget that.

Now, all that I can really offer is that I will have you and your husband in my prayers and I’m sure there are many others on this site that will do the same.

Good luck,


You know you're wired when...

You can hear your heartbeat in your cell phone.

Member Quotes

My cardiologist is brilliant and after lots of trial and error got me running. I finished this years London Marathon in 3hrs 38 minutes.