Pacemaker Leads

I just have a quick question for those with a pacemaker.  I received my first pacemaker in 2002 after my heart transplant. I received my second in 2011. My last interrogation showed that I only have 15% battery left, about 9 months if I'm lucky.  (I'm paced 95% in my atria).  I have my original leads.  Has anyone ever had their leads changed?  I will have had these leads for 18 years in July.  I'm going to ask when I see them in March about it, but I'm just curious about others.  Thanks!


Lead extraction

by heckboy - 2020-01-31 17:23:03

Hey there, 


I've had leads extracted twice, the second time was just two weeks ago. It was a different circumstance every time. What can I tell you? 


by new heart - 2020-01-31 17:41:37

I'm just curious about anyone having their leads in as long as I have, 18 years

Old leads

by barnet38 - 2020-01-31 18:40:02

I'm also interested in hearing about your experience.  My leads are 21 years old and my EP wants to do an extraction.  One of my leads had a problem about 1.5 years ago and had to be switched to unipolar mode.  He wants to extract that lead and place a new one.  I'm 38 years old, healthy, active, and have no other diseases or health concerns, other than CCHB which is the reason for the pacemaker.

Leads Change

by Good Dog - 2020-01-31 20:38:22

My Atrial lead is 33 years old and my ventricular lead is 25 years old. I have never had an extraction. I would think that if there is nothing wrong with your leads they would not remove them just based upon their age. There is considerably more risk with extractions than insertions. 

Leads Issue, Replace Lead and keep or remove the failed lead

by webbonwa - 2020-01-31 22:32:05

My lower pacer lead was replaced as soon as possible after it was installed and found to be not working. That was about 1-1/2 years later due to conflicting circumstances. I studied the issue of replacing leads or not by researching the Internet.I found that it was a good decision to either leave the old lead in place while inserting a new one or to remove the old one. Removing the old one is harder the older you are and it also can get infected. Taking out the lead is problematic because the surgery is more invasive. So the risk is higher to do that. But they have new tools to help now. so the risk is added to take out the lead earlieer in your life your body can probably handle it better. Also an older lead might be more embedded and more difficult to remove.

The way they do the lead replacement at John's Hopkins and other research hospitals is to prepare the person for open heart surgery in case there is a misstep and the heart must be repaired immediately, they are ready. That's the way I asked them to do it for me at my local but good hospital. They preped me and used the new removal tool which sheaths the lead to prevent ripping the heart muscle on removal. Was successful.


by kathleenswaffordd - 2020-02-01 06:22:16

I should say only that its awesome! The blog is informational and always produce amazing things 


by new heart - 2020-02-01 08:26:04

Thanks for all of the responses! Very informative and things I really never thought of!


by Tracey_E - 2020-02-01 11:03:32

I got mine in 1994. One lead went bad around 2010. There was room so they capped off the bad one and added a new one. My other original lead is still going strong. So, no extraction here yet. Average lead life is 15 years but they can last much longer than that. There is usually plenty of warning when they are going bad. 


by heckboy - 2020-02-01 11:58:21

I still have one lead from my original PM from 2004 and have had two lead extractions. For the most recent one, they inserted a temporary PM in my thigh since my resting rate is around 30 BPM. For my first, it wasn't neccessary since it was supbstantially higher. The result is a stich and some bruising. The site was closed with tape. I'm sure I was prepped for a worst case scenerio, but it all went smoothly. For some reason, they decided to insert a catheter this time, so now I am somewhat closer to understanding what it's like to have a baby (ouch!)

No warning for bad lead

by heckboy - 2020-02-01 12:05:29

One thing to add, my bad lead was discovered when minor noise was detected during my regular inspection. Before then, I had a few instances of getting dizzy for a a couple of seconds, but didn't suspect a lead. They had me back the next day to replicate the noise, took a chest x-ray and did an ultrasound. I had the lead extracted about 10 days later.


by dwelch - 2020-02-01 22:30:54

Someone above has just over the age of mine one is 32 years another 25 (an original one broke during first replacement its capped off and still in there) and a new one about 2-3 years old.  Going strong no need/desire to change any of them out, nor remove the unused one.  Unless your body is rejecting everything, or one is broken then there should be no reason to remove them.  



Lead extraction

by heckboy - 2020-02-02 02:53:36

I think it comes down to if the Dr. think one is a good candidate for lead removal and you want it. Deciding factors can the patient's age, size of veins, etc... they used to leave the old leads in simply because they weren't able to extract them. The surgery is only about 25 years old, and I'm talking about the first successful one! Your mileage may vary (it's clearly safer to leave them in), but I like the idea of not having my old dead leads inside of me.


by Tracey_E - 2020-02-02 09:36:11

I already know when the time comes extraction for me will be risky. Every year I can wait to do it, the better the technology gets for removal, the better the new leads are.  I'm 53 now so the longer I can put it off, the better the chance that my next set of leads is my last. That's why I chose not to extract since I had room to add another lead. My ep keeps a close eye on my leads, not just the interrogation but with xrays and ultrasound. 

It was 5 years from the time the impedance went up and we knew insulation was ruptured on the bad lead until the time it was replaced. They cranked up the juice to get the signal through which shortened the battery life but it kept pacing right up until it was turned off. It was my choice to do it that way (my doctor agreed with me), I was more concerned with making the lead last than battery replacements which are super easy. Extraction isn't nearly as risky as it used to be but I'm still happy to sit back and wait while they continue to perfect it! 


by Dave H - 2020-02-15 15:40:29

The words from my EP yesterday: "Your  8 yr. old third lead isn't doing anything - other than draining the battery - it's time for a decision on your part. BTW: I've forgotten how a three lead setup works - any hints?  EP wants to go in for a look. He knows the third lead was never installed in an optimal position (by a Dr. affiliated with St. David's in Austin along with the Bozo EP affiliated with Texas Cardiac Arrythmia Institute). Current EP wants a look/see - replace lead? Leave it in place? Do some work around my bundle of HIS?  He's offered no guarantees but wants to try.


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