dislodged atrial lead

I had CRT D device procedure on 1 July 2019 for LBBB and heart failure following viral myocarditis couple of years ago.

i had my first follow up appointment today and i was informed the atrial lead ia dislodged and migrated to the Rt ventricle. The device was switched off and a provisional date of 7th August was booked for lead replacment.

i am really worried and need to know what the outcome could be. 

1 Comments

Reposition atrial lead

by crustyg - 2019-07-18 04:39:51

Hi Hishambaroudy:

They will open up the pocket - probably just using some local anaesthetic - disconnect the atrial lead from your device, withdraw the lead partway, put a stiff guide wire down the middle to give the lead the correct shape to help get it into the correct location and then place the lead where it needs to be.  Check that it's doing what's needed from an electrical aspect, remove the guide wire, reconnect the lead to your device, recheck, refix the lead to the base of your pocket, close up the opening to your pocket, apply a fresh dressing and encourage you not to lift your arm on that side so that the elbow stays below your shoulder for several weeks.

It should be a fairly quick procedure with little discomfort for you.

The worry should turn out to be worse than the reality.

Then you'll be back where you were before the lead became dislodged.

Good luck.  Don't be too hard on yourself: approximately 10% of atrial leads become dislodged in the first weeks after implantation - after that some fibrous tissue tends to grow around the lead where it is anchored to your heart muscle making the lead placing much more certain so leads rarely dislodge after the first few weeks.

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