Lead defective after 9 years - Dr. wants to replace and leave old one in ?

I am now 81.  Had original pacemaker for 8 years and it was replaced in January, 2020.  Started having lightheadedness and "pocket stimulation", i.e., intermittent visible throbbing of the pacemaker site a few days ago and ended up in ER.  Lead x-ray shows kink in one of the 2 dual chamber leads, which was also there on previous x-rays.  For various reasons Dr. believes solution is to replace the kinked lead (which pacemaker tests show is the problem) and leave the old one in the heart.  The initial fix a few days ago was to increase the voltage through that lead, which has taken care of about 90% of the problem, but now have only 2 1/2 years battery life on the new pacer.  Does not appear to be any infection and best guess is that there is an invisible crack, etc. on the lead.  Anyone have similar situation?  The original St. Jude pacemaker placed in Orlando.  Now living in Jax Beach and going to Mayo - Jax, who put the new pacer in January.  Does this sound right or should I get a second opinion?


Probably a good decision

by Protimenow - 2020-07-02 18:07:27

Admittedly, I haven't had to face this issue. My pacemaker and leads have been in me for less than two month. 

However, it's probably safe to assume that the old lead has scar tissue around it, and it's been embedded in your heart for a long time. Removing it sounds like it can cause serious problems. 

Placing a new lead is probably the easiest, and safest, way to handle your situation. 

At least, this is the way it's striking me. 

No advice -- just opinion

Not a Problem

by Swangirl - 2020-07-02 18:25:30

Many of us have a capped off lead that was left in there.  Mine is more than 30 years old and hasn't worked for more than 10 years.  It's very risky to remove an old lead.  My doctors said if I wanted it out against their advice (I didn't) I would have to go to a large medical center who has a specially trained team who does this frequently and can do it more safely.  It has more to do with whether your veins are big enough to accomodate multiple leads.  I assume yours are.


by AgentX86 - 2020-07-02 22:24:29

It's normal to abandon a lead in place as long as there is room in the vein.  As others have said, the lead gets "welded" into the veins and heart.  It's a major deal to pull one out.  Sometimes is necessary, though, and when it is you should go to a specialist who does this for a living.  If there is no immediate need to remove it, it's better to wait until next time you need a new lead (if you ever do).  Procedures, in this area, are constantly improving and becoming safer.  You have the opportunity to take advantage of this (and perhaps have one fewer complex procedure in your lifetime).

got one

by dwelch - 2020-07-02 22:55:21

I have a 33 year old lead that was left there 25 years ago, back then you didnt remove leads now is a different time.  But if you dont need to then you dont need to.  I just got another lead so I have a 33 year old lead I am using a 33 old lead I am not, a 25 year old lead I am using and a 3 year old lead I guess that I am using.  All four on the same side.  If that fourth one didnt fit they were going to pull the broken one or run it down the other side then tunnel across the chest.  It fit.

The broken one is capped off, no worries.  Fewer worries than going in and trying to take it out.  Yet today removing leads is a thing and even recently on this site one/some folks have had leads and whole setups removed.

Leaving a defective lead in the heart

by bikengolf - 2020-07-03 09:33:49

Thanks, all for this reassurance.  Also, thanks for taking the time to share.




by Tracey_E - 2020-07-03 09:34:42

Been there, done that. I had one lead that wore out, likely ruptured insulation. They cranked up the power on it to keep it pacing but that quickly drained the battery life. There was room in the vein so when they replaced the box they capped off the bad one, added a new one. That was in 2010. My other lead is still going strong. They could remove and start over but that's a much more involved surgery. If you are happy with your doctor in general, I would not bother with a second opinion. 


by Finn - 2020-07-15 13:10:25

I had my leads extracted and reolaced after 9 years.

also st Jude., ask what kind of leads were used, mine were tendril 1888 tc or it should be on your I'd card.

there are studies on these leads going early. 

You know you're wired when...

You have a $50,000 chest.

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