upcoming 2nd opinion - questions to ask?
Upcoming 2nd opinion from an EP and I'm looking for help on figuring out what questions to ask and the best approach to take with the new EP.
Background: I am 5 months post-op, dual chamber "on demand" pacemaker implanted for 3rd degree AV block caused by swallow syncope. Complications caused by small, inaccessible veins resulted in a micro dislodgement of the right ventricular lead that is currently only sensing an average of 2 mV instead of a desired minimum of 5 mV.
Other than feeling really emotional and asking "how can this possibly be good enough for the rest of my life???" I'm at a loss for words and definitely need to go into the consultation with notes (and stick to them).
Is there a really simple way of asking the new EP if he thinks the lead should be replaced or left as is? My pacemaker's programmable sensing threshold is currently dialed up to the 3rd highest setting, which doesn't leave much room for future adjustments. If the lead gets weaker over time, how will they be able to replace it, given the issues they had with my veins when it was initially implanted?
The first surgeon was a total jerk and I don't even want to discuss that with the new EP. This is the situation. What can be done about it? Pro's and con's of dealing with it now vs. later. For how long will 2 mV be good enough? What is the criteria for replacing it?
Also would the new Medronic Micra AV be suitable for me, if/when it is available in Canada?