Hi all, need an answer quickly please

You are fine

by Good Dog - 2016-12-25 19:39:33

Frankly, if you did that the day you came home from the hospital you'd probably be fine. I am confident you have absolutley nothing to worry about.

If you did any damage you'll be aware of it pretty quickly. It is highly unlikely as they just tell us that as a general precaution. It is seldom ever a problem.

Have another Martini.......................and don't worry!!!!

MERRY CHRISTMAS!!!!!!!!!

How you would know...

by donr - 2016-12-26 02:08:15

...if you pulled a lead out.  You'd suddenly feel just as crappy as just before having the PM implanted - why?  because you would no longer be paced!  If you suffered Bradycardia, your HR would drop back to where it was before implant.

Why won't it very likely happen from what you did? Because there is a bunch of slack in  the lead due to the lead being manufactured for a whole range of people sizes.  They don't typically use leads that are "Just right" in length, just to give you that slack.  Next, a sheath is placed around the lead just where it enters the vein.  The Sheath is sutured to the fascia of the vein & from the description I read in the Medtronic lead manual, the sheath intrudes slightly into the vein.  The Lead is then fastened to the sheath w/ another suture (or two).  This prevents GROSS movement of the lead either into or out of the vein.  The slack lead is coiled up & placed directly behind the PM in its pocket. Face it - the human body (erxcept for bone) stretches & moves quite easily.  In order to extract the lead from its mooring deep inside the heart, you have to make a pretty violent move that is quite long to pull all the slack out of the lead, dislodge the anchoring sheath, stretch out all the slack in the lead inside the vein & heart chamber & tug on it enough to pull its anchor out of the heart wall. 

According to my MD Daughter, who has had surgery training, There are itty-bitty, teensy-weensy muscles in the walls of veins & arteries that grip the surface of needles when they are stuck though them & perform an initial sealing when they are removed that is quite rapid.  Remember what it is like to have an IV lead installed?  They shove the needle in & there is usually very little blood released, even though it goes into a reasonably large vein.  They pull the needle out & put immediate pressure on the exit & there is very little release of blood (usually).  The same thing occurs when they put the leads into the vein beneath the collar bone - it has a name (No, it's NOT Fred, it's the Subclavian vein) & it's pretty large.  Why do you think that you don't bleed badly around the leads where they go into the vein?  It's because the vein grips the lead tightly & seals off the insertion point.  The anchoring sheath is there to prevent movement between the vein & lead after you are sewn closed.

For the host, doing what you accidetally did is a "Not to worry" event.

There are limits, however.  DO NOT grab a banana from the kitchen, run into the dining room, leap up on top of the table, Jump up & grab the chandelier with the hand on the PM install side, start swinging back & forth while peeling the banana w/ your teeth & eating it!  That is an almost sure lead pulling exercise!

Be of good cheer!

Donr

Arm positioning after pacemaker insertion

by Selwyn - 2016-12-26 07:04:34

Hi, worry not!

I have recently replied ( please use the search facility on the upper right: 18th December 2016, 'Arm Position after PM insertion') to a similar query. Hospitals differ as to the advice they give post op. PM insertion- the range is "do what you want as long as it doesn't pull on the surgical wound" to "don't lift your arm above shoulder height for 6 weeks."

There is no  medical evidence to support any case. All appear to be equally good with regard to lead problems.

Donr gives us a detailed idea as to why these things don't matter.

Selwyn

If you can handle it...

by donr - 2016-12-26 10:11:59

...here's a video of an actual PM implant, showing all the procedures I wrote about in my previous comment.  It shows all the slack in the lead & the little sheath used to protect & anchor the lead at the insertion point into the vein.  It also illustrates the small amount of blood leakage where the lead enters the vein.

https://www.youtube.com/watch?v=QeRFer4_sGs

Donr

Thank you all!

by Ileen - 2016-12-26 10:39:36

Thank you for the help again everyone. After I digest my breakfast I will check out the video don't!My mind worries too much these days!! Gotta chill!! Ileen

Simplistic Answer

by Grateful Heart - 2016-12-26 10:47:46

Picture an electrical outlet box in your wall.  The wires are not taut....there is a lot of slack that is coiled and placed in the box.

If you look at an x-ray of your PM, you would see the same thing.  Ask to see it the next time you have an x-ray of your chest.  It's pretty cool to see.   

If you have no breathing difficulty or difference.....you are fine.

Grateful Heart