How do I know if I've pulled the leads out

I had my first PM installed seven days ago and I have to say, it's been uncomfortable since about day three. Runs of tachycardia (about 10-15 per day) - and I was bradycardic before the PM! I may have stretched my arm up a little high. How do I know if I've pulled the leads out?

Thank you in advance. 


It's unlikely

by crustyg - 2019-11-05 06:02:52

Most EP docs use actively fixed leads these days - there's a little metal corkscrew end that is anchored to your heart muscle.  This, combined with plenty of spare lead, gently looped inside the heart, makes it uncommon to dislodge a lead through an occasional over-high lifting of the elbow on the implant side.

Secondly, if you've had a PM for bradycardia and now you're seeing tachy episodes it's probably due to the PM+leads actually working, which would suggest that your leads are still pacing your heart.

How do you know for certain: you can run an ECG on yourself (little portable units are available for about USD 100), or you can get your primary care practice to do this (they should be able to see a small pacing artefact on the ECG), or get a CXR done if you're really worried.

Your next PM follow up will provide a certain answer as the PM will see lead faults, changed impedance, no capture etc.

Highly unlikely

by AgentX86 - 2019-11-05 10:35:34

If you pulled the leads out  your heart would revert back to its unpaced norm, which in your case is Bradycardia,  not tachycardia.

You might want to try to capture a tachycardia event on your remote monitor (assuming that you have one). Your PM tech can then tell you what's causing it. It's probably just your heart getting its revenge for the surgery and being paced.

Pulling out the leads

by Elevator tech - 2019-11-07 14:38:07

 I’ve had my pacemaker exactly 3 weeks  I was off work for 10 days no I’m trying to take it easy I’m on light duty but I find myself overexerting myself and lifting my arm over my head  I haven’t pulled them out yet and I hope I never do I guess all I can say is be careful

Thank you all

by Kell-M76 - 2019-11-08 02:27:36

Thanks so much for your responses. I went to see my cardiologist who checked it all out for me. My rate was set a little high and the pain was due to me moving my arm too much. Apparently when he said "use it normally without lifting it above your head" meant "dont use your arm unless you have to". So all sorted now. 

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