Extraction of single lead and pacemaker and replace with pacemaker and 2 leads

Hi Mia

by NiceNiecey - 2018-05-04 02:48:12

I have very little direct knowledge related to your questions but many others on this site do and I’m sure they’ll weigh in.  One thing that I do know, however, is that the vast majority of PM owners have a dual-lead device.  You’ll be in good company!

Why two leads? A very simplified answer.

by Gotrhythm - 2018-05-04 12:34:24

Watch a video of how the electrical impulses go through the heart when it beats. I always seem to understand it better when it's an animation.

You'll see that in the healthy heart the electrical impulse starts in the sinus node and spreads downward through the heart, first the upper chambers, then a fraction of a second later it gets to the lower chambers and they contract. Sometimes the electrical problem is in the upper chambers, sometimes the lower, sometimes both.

Most EP's these days, give everybody two leads, on the theory that if they don't need both today, they might someday. If you're going to go through surgery to put in one lead, it's not that much harder to put in two. 

When I first got my dual lead pacemaker, my sinus node didn't always pace when it was supposed to, but when it did, the electrical signal moved through my heart just like it should. So for a while, only the arial lead (the upper lead) was doing anything. The lower lead was just there, in case it was needed. Five years later, my heart changed. The signal wasn't getting to the lower chambers as it should. No problem. Becuase it had two leads, one to the upper chambers and one to the lower, my pacemaker was able to take over the pacing of the lower chambers too.

And just so you know, sometimes three-lead pacemakers are required when the two lower chambers, the ventricles, aren't pumping together the way they should.

Thank you gotrhythm

by Miawaka - 2018-05-04 22:46:16

Do you feel the pacemaker when it paces? I never notice the one lead I have now when it paces. I will watch some videos as you suggested. Thank you for your time. This double lead scares me a bit because I have only had one for the past 6 years. Thanks again for responding. 

Feeling the pacer

by Bugsyu - 2018-05-04 22:56:47

miawaka, 

i just had my pacer put in last week and I swear I felt a very sharp hot pin prick right below my nipple.  It always happened when I paced 3 beats at a time.  Now (a couple days later) they have adjusted my meds and I’m not feeling it anymore. But I think it’s not unusual if u do.

Feeling it

by Gotrhythm - 2018-05-05 18:38:40

I have never, ever felt my pacemaker pace my heart. I'm paced at practically 100% in the atrium--where the upper lead is---and around 30% in the ventrical---where the lower lead is.

If you haven't felt the pacing with one lead, I can't imagine why you would feel it with two.

Four days after surgery and blisters from adhesive

by Miawaka - 2018-05-12 17:38:35

Well, everything went well during surgery. Grateful to have broken lead out and new pacemaker with 2 leads. EP placed this one deeper than previous pacemaker. First pacemaker was just under skin and could be seen easily. 

Only issue I am having now is blistering from adhesive tape. I have one blister that burst and now skin is raw and red where it burst. I think it is best to keep it exposed to air so it can heal but a friend of mine is insisting I put antibiotic ointment on it. Any thoughts or experience with this would be gratefully appreciated.

Thank you all for your comments and addressing my concerns before this surgery took place. I was so afraid of an extraction and all of you helped me be at peace about my surgery. 

Though we may never see each other face to face, I am soon grateful you are all in my life. I am beginning to be more active and sharing my experience,strength and hope with new pacemaker recipients. 

Miawaka