Risk in replacing atrial lead

leads

by Cabg Patch - 2017-02-13 11:05:14

if your lead isn't operating properly, then it should be replaced, otherwise what's the point of having the device. Kind of like my car sityting in the garage unused the past year...

Frequently, they just add a lead and disconnect the non-functional one but leave it in place. The risks of lead extraction are overplayed and a source of urban legend that just won't die. I had 3 leads extracted after 10 years with no problem. I know numerous others in the same situation. Yes there's always risk anytime a medical procedure is undertaken, but this is a common procedure and highly successful. Do what you are comfortable with but know the facts, and consequences of either decision...

lead removal

by Tracey_E - 2017-02-15 13:56:30

Once upon a time, it was a risky procedure but not any longer. The lasers they use have come a long way and the number of experienced doctors has increased. Ask your doctor how many he does, you may want someone more specialized to do it if he does fewer than 100 per year.

When my lead went bad, I had room for a third so I went with that option for now rather than extracting. They did a venogram in the cath lab to see how much room was there. 

Venogram

by Heartfelt - 2017-02-15 16:38:01

Thank you both. I didn't know about the venogram test and will definitely pursue it to see if they can just add a third lead.  And yes, I'm going to seek a surgeon with the laser experience. 

venogram

by Tracey_E - 2017-02-15 22:09:34

You might have to ask. For some reason I will never understand, they want to do it during the surgery. I got into an argument with the first surgeon I talked to who said he'd see if there was room when he opened me up and decide then what to do. Uh, no way! I wanted to know the plan before and be part of the decision, not be surprised when I woke up. He also said something about running it from the right side rather than removal but that seemed kind of convoluted to me to have one lead on the right and one on the left. I did not go back to him ;) Anyway, ask if they don't bring it up. If you have an issue with scar tissue they may not want to add to what's there but it's definitely worth asking and taking a peek at what your veins look like before making any decisions. It's a super easy test, they just run dye in the iv and look at the xray. 

broken lead

by dwelch - 2017-03-14 00:45:58

One of my leads broke when they were replacing pacer number 1 with number 2.  They added another lead and capped the broken one, been carrying it around for 30 years.  Am facing a possible removal if there isnt room (need another lead for a three chamber in the next few weeks).

I agree with the other answers that without the leads working what is the point.  Find out of you have a good lead removal person in the area, do they do a lot of them a year.  You can probably just have another lead put in and cap the broken one.

Note the leads do normally grow scar tissue, now maybe yours was unusual, but there is a period with a new lead where the scar tissue forms, jab a wire into your arm, whether you leave it there or not some scar tissue will form, no different than on the heart muscle.  Just saying there is normal scar tissue, in your case they may be saying yours is excessive.  It does affect the settings on the lead, 30 years ago I had to wear an monitor so they could dial in the settings, to much you get double beats, too little, none, but after a few months the scar tissue settled in and we got the settings.  todays pacers just deal with that themselves dont require several visits to dial in a setting.

Reply to dwelch.

by Heartfelt - 2017-03-14 04:37:17

Thank you for that information. My EP rescheduled  my followup to late April and in the meantime I won't go to another EP  (which would be a 4th opinion).  Or, maybe I should??  I will ask about the  venogram, a third lead and getting a laser specialist to do the surgery.  Thank you to everyone on this Pacemaker forum.