Scared to have 11 YO Lead Removed

Was diagnosed with VT in 2005 SCD in the family brother had an MCI at 37 and Uncle at 44 both DOA. So, doctors decided to install a Guidant ICD device. A month later it was recalled. Four years later I had the Guidant device removed along with a bad lead in 2009 and then a new Medtronic device installed at Yale New Haven. Then Medtronic recalled the Sprint Fidelis 6949 which I have. Also a tech inadvertently programmed my device in early 2010 to not let my heart go below 100 BPM and it was almost 4 months before a tech discovered it when he asked me how i was feeling during device interrogation and I asked him why he was asking and he said because your heart has not gone below 100 since the last time your device was interrogated. I have never received a shock/therapy ever in the 15 years I have had these devices. I have had a negative experience with the hardware. My battery is now totally EOL I should have had it changed on early 2019. I am scared to have the Sprint Fidelis lead surgically removed sounds risky. I still have episodes on NSVT but no SVT. I am leaning towards having the device replaced and abandoning the bad lead and have them implant a new one. Wish me Luck.





by AgentX86 - 2020-04-21 19:07:50

Question:  When you say you've had NSVT but no SVT?  They're not the same things.  NSVT is a (non-sustained) ventricular tachycardia and SVT is an atrial tachycardia (supra/above ventricular tachycardia).  Of the two, NSVT is much worse and a very good reason to have an ICD (if it becomes sustained). The fact that you haven't had the "Jesus jolt" is really good news.

If there is enough room in the vein to run another lead, abandoning the other is a good option.  The possible drawback would be MRIs.  They don't like doing MRIs on us to begin with but, as I understand it, an abandoned lead makes it really difficult to impossibe to get one.  I don't think I'd like that limitation. 

As you point out, removing a lead is does have a non-negligable risk.  If you go this way, make sure you find someone who does this for a living and not much else.  Your corner EP is not the one to do this. Your choice, though.  I think I'd go with the removal if I could find an expert (lead removal) EP to do it.  You can't abandon an infinite number of them.

It's amazing that you didn't feel your heart rate stuck at 100bpm.  Mine is set to 80 (daytime) and I don't like it much at all (but better than PVCs).  I'd go nuts if it were 100.  I'd make your EP have a long talk with that PM tech. A sustained 100bpm doesn't do your heart any good either.


by Tracey_E - 2020-04-22 10:48:13

Had a long response written and the site burped and lost it! So, here goes again...

Fifteen years ago extraction was virtually unheard of and risky. Ten years ago it got more common. In the last five years, advances have been made in the lasers they use and the number of experienced surgeons has increased. It's to be taken seriously but it's no longer considered especially risky. We have had a lot of members, some with leads a lot older than yours, successfully extract. I can't remember the last time we had a member with complications from an extraction, probably at least 5 years. You want it done by someone very experienced, preferably at least 100 per year, even if that means traveling to have it done. 

They can do a venogram, which is an xray with dye done in the cath lab, to see if you have room for another lead. That might make it easier to make a decision. When I was in that situation, I had room so chose to cap off the old and add a new one. Another option is run the new lead from the right side. I chose not to do that because I want to save the right side in case I ever have problems with the left side. I'm 53 now and have been paced 25 years, so I have a lot of years of pacing down and a lot more to go. The main reason I chose not to extract is the hope that if I put it off, then my next set of leads might be my last. When one of my current leads goes bad, I will have them all extracted because I don't have any more room in the vein. 

With 11 year old leads, MRI is not an option now. If that's important to you, then that might be a reason to extract and start fresh with MRI-safe leads. 

Thank You

by Proud American - 2020-04-22 11:04:07

AgentX86 & Tracey E thank you both! I wish I had found this site 10 years ago! X86 I was originally diagnosed with NSVT and SVT oddly I have not had an episode of SVT since 2011? I quit smoking and drinking in 2013 which has been wonderful to say the least except for the 25 lbs I gained. I was hoping to hit the treadmill before surgery but apparently that is not recomended until I have a new device. Like I said the lead removal in 2009 sucked 4 hours just to get the lead out. If I go for the removal I am leaning towards Zdr. Jude Clancy to do the extraction from what I have found in my research he is qualified? I would welcome any member feedback! Thanks! Andrew

finding a doctor

by Tracey_E - 2020-04-23 11:03:57

It's ok to ask them how many procedures they do, and also how many times they've needed to use the cardiothoracic team (that's the back up if things go wrong). 

You know you're wired when...

The mortgage on your device is more than your house.

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I am no expert, but I believe that without the defibrillator that I have, I would be dead.