second lead ?

HI all, 

I had my first pacemaker implanted in 2007 and had ithe battery exchanged in 2017. Unfornately my cardiologist was not able  to remove the lead to the atrium from the old pacemaker. All types of people helped with different tools, but they gave up after 2.5 hours, cut the lead off the old pacemaker and capped it. So now I only have a lead in my ventricle. Since that time I have recurrent VT of a few seconds each. I'm wondering if is related to only having 1 lead instead of 2, or completely coincidental. I'm having an echo done tomorrow to see if there is any structural heart damage, I hope not. Anyways, my question is ,,,,, could the doctor not go back in and place another lead next to the old one? I have read that the vein or artery fits 2 leads.

thanks 


3 Comments

Consider getting a second opinion

by Gemita - 2020-08-12 00:36:29

Hello Beulahdarling,

You ask about placing another lead in the same vein.  I am certainly no lead expert but I would imagine that it would very much depend on the state of the vein where the redundant lead resides.  There may well be sufficient space for a second lead but if, for example, extensive damage has been done to the vein or it is not in a good condition to accommodate another lead, your doctors might want to avoid placing a new lead in the same area.

It sounds to me as though you should perhaps find a more expert centre for lead extraction and new doctors to discuss all your options.  

The short runs of VT could just be coincidental or point to the start of another heart condition, so this really needs to be assessed.  I can get runs of VT when my dual chamber pacemaker switches me from atrial to ventricular pacing during atrial tachy arrhythmias since I am very sensitive to being paced in my right ventricle and only feel comfortable when pacing switches back to the right atrium.  Maybe you are beginning to experience symptoms of loss of AV synchrony from the loss of your atrial lead, so this may need to be discussed with your doctors.

I hope all will be well with the echo

space

by Tracey_E - 2020-08-12 09:25:57

It depends on your build, the condition of the veins, and the size of the current leads but usually a vein can hold 3-4. I was in the same position. They did a venogram, which is an iv with dye in the cath lab and we saw that there was room for another lead. It ended up in the same vein but they went in a different place. They usually go in subclavian. For my extra lead they went in (I think!) the cephalic which is closer to the shoulder and leads into the subclavian. They can also run it through the right side or remove all of it and start over fresh. Since you just had a replacement, adding a new one is certainly the easiest approach. I was given the choice to add or extract. 
 

Edited to say axilary is where the new one is not cephalic

four

by dwelch - 2020-08-12 16:15:50

I have four leads on the same side.  One broken one and three in use.  The first break happened early on so 7 years with two leads 23 or so years with three leads one broken and now a few years with four leads one broken (switched to biventrical)

Depends on you as to how many you can hold on that side.  they can put one down the other side and tunnel it across your chest to the device if there isnt room or move the whole thing over to the other side

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