Leadless VS Leads

A few months ago I posted the message below:

Hello, I am 27 years old. My story began in April 2018. At the time, I thought I just had nausea and vomiting, went to the ER, they said everything was fine and went home. Next episode happened in June/July. I completely passed out twice. Both times while sitting down. Second time I was sitting in bath tub, boyfriend found me passed out and lifted me up and was shaking me awake. He said he thought I was dead. He said there was no response. Called 911, sat in ER with monitoring. Told Dr. I was having same symptoms as before, when I passed out. Stayed alert but monitor recorded my heart paused for 5 seconds. The whole staff pretty much told me a was getting a PM. Went to cardio unit for 2 days under observation. Cardiologist said everything looked fine and sent me on my way. Next episode happened in August. Felt same as when I was in ER. Emailed Cardio, scheduled tilt table test. Test was at end of August. Passed out at 40-minute mark. Recorded a pause of "at least 20 seconds". My cardio sent me for a second opinion. Second opinion suggested medication. I pushed for loop recorder. I got recorder implanted at end of October. Only symptoms recorded so far are Tachy. Apple watch has recorded HR as low as 36 bpms. 

So, to break it down:

Recorded two pauses so far: 5 seconds and 20 seconds

Tachy recorded

Brady recorded

 

My Cardio and I talked yesterday and basically he said it was my choice for pacemaker or not and mentioned that the leadless pacemaker might be right for me. Does anyone have any experience with leadless or have any suggestions to which route I should take?

5 Comments

No expert

by MissAshleigh - 2019-04-18 13:55:53

Mine has 2 leads. I’m 41 w/ a history of passing out & hitting my head. Wore a monitor for 9 days, first morning woke up to 4 phone calls. 9.6 was my longest pause. 

They told me to GTF into the ER for a pacemaker (my hospital has a highly renowned chest pain/heart center.)

20 seconds is a long time; not much longer & you’re pushing organ failure & brain damage. (& do you drive?)

Regardless, you don’t want to play around. Leads or no leads, IDK, but I see nobody else has responded, so my ¢.02.

Please be careful. I put mine off for 2mo & had a HUGE panic attack in the lobby, but once I was in back, I was NICELY drugged (ketamine! Ha!) & my recovery has been almost painless (weird, but not painful.) Nuts. 

 

Wish you luck regardless! Hope someone responds re: leads!

 

 

Pacemaker is a lifelong commitment!

by Pinkit94 - 2019-04-18 13:59:37

Leadless pacemaker also known as Micra is a great option for young and realtively healthy people, you dont have a large scar, and don't have to be concerned about breaking leads(trust me I have an ICD with pacemaker and i broke my leads by just swimming "too much", in the middle of summer, not fun), it is newer technology, with that being said there are limitations of our full understanding of it and so getting insurance to cover it might be an issue as they might see it as "experimental". The limitations of having a leadless pacermaker are, once the battery depletes (around 8-10 years) instead of replacing it, they will just leave it in/ turn it off and place a new pacemaker. Another limitation is that if you ever would need to add another lead due to worsening heart conduction, this would not be possible. In that case they would turn off Micra and still put in a traditional pacemaker with two leads. Most important question to ask your MD: would placing a pacemaker help with passing out? because there is a chance that it might not help! Most likely you would need a pacemaker with rate drop response, I'm not sure Micra has that. I think you should call your MD, to really discuss the benefits vs risk with each type of device.Passing out because of a pause in a young person, is concern as it might endanger you and others, however, a pacemaker(regardless of the type) is a lifelong commitment that doesn't end at just implantation, there are at least 2 office visits a year for check ups. Also a pacemaker can limit what jobs you can have, future insurance coverage, etc.

I worked in Cardiology EP device research for 4 years in a major university hospital in NY, so if you have any further questions, please message me! Best of luck

 

Response to MissAshleigh

by karbear6556 - 2019-04-18 14:38:24

I do drive....Which is honestly one of the most scary parts to this. I try to be as safe as possible...I do have warning signs prior to passing out, so I pay close attention to those. 

 

Thank you for your response!!

Response to Pinkit94

by karbear6556 - 2019-04-18 14:40:21

According to the Tilt Table results, I have a cardioinhibitory response, so my heart rate starts dropping, then eventually stops. So I do believe a PM would help...

 

Also, thank you for your response!!

Useful info from Pinkit94

by LondonAndy - 2019-04-19 08:06:25

I have a regular, two lead pacemaker and am 100% paced.  It happened under an emergeny situation so I didn't have time to do any research, but it is good that you are doing yours and accept that you need a pacemaker.  Just a quick reminder that it is in the nature of forums like this that people come with their problems, and it is wonderful to share knowledge etc, but there are hundreds of thosands of pacemakers inserted every year routinely and without problem.  So just because someone might have a particular issue does not mean you will, and the important thing is to get it done and get on with your life safely again.

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