Lead Extractions - New Leads

Hi all. I am heading to see a surgeon on Thursday to talk about the recommendation of lead extractions (4 leads, oldest implanted in 1994) and placement of two new leads. I am 42 years old, pacemaker since age 5 for congenital heart block. Heart function & strength looks great - no issues there. When I got my last device 4 years ago they considered extracting at that time, but decided against it since they were working fine. Now, lots of noise and heart beating super fast/super slow at random times and causing some fatigue and discomfort. Anyway, who has had a similar procedure and what questions should I ask on Thursday? Any idea on recovery time (time off work)? I live in Iowa and the procedure would be in Des Moines at Mercy Hospital. They will not be putting a new pacer in at the same time - just the new leads. Thank you for any insight, advice, questions I should ask, or things I should prepare for.  


6 Comments

Prayers

by Uniqueonne1 - 2020-10-20 13:00:38

Pray all went well !

Lead extraction

by ar_vin - 2020-10-20 13:20:40

First, I have no experience with lead extractions But like with any significant surgical procedure you must seek out the best surgeon. The best implies some one who has done hundreds of the specific procedure and does many consistently - in this case lead extractions.

It's not the hospital as much as the specific EP/surgeon. Travel if you must to a surgeon who does a large number of lead extractions.

Ask any surgeon you might consider for the lead extraction:

- number of procedures they have performed and do perform each month

- success rate of lead extractions

- risks of procedure

- options

I'm sure you'll hear from other members who have significant personal experience with lead extractions.

 

 

extraction

by Tracey_E - 2020-10-21 10:32:29

I haven't had one yet but it's in my future so I've had extensive discussions with my ep.

- Ask how many they do, you want it ideally to be 100+ per year.

-Ask how many times they've needed the cardiothoracic surgeon that they keep on standby. My ep's team has needed the back up 4 times, all 4 patients recovered fully. That's for all of the extrations his entire team has done, ever. 

-Ask what your risks are. My doctor explained to me that I will be high risk because 1) placement of my leads and scar tissue on them and 2) I've never had any kind of heart surgery or ablation that would cause scar tissue which toughens up the heart. (paraphrased)  My doctor is highly specialized and does a lot of extractions but he said there is another surgeon across town at the university hospital that has more experience with high risk so that's where he plans to send me. 

Good luck!!!!!! We've had quite a few members have successful extractions, hopefully one will chime in soon with first hand experience. 

Lead Extraction

by FirstDuely - 2020-10-22 02:48:13

I got the first dual chamber/2 lead pacemaker in the US back in 1986.  The leads were very thin walled and eventually failed by cracking in 2001.  Dr. Isaeff at Loma Linda Heart Institute sent be to a cardio surgeon at Provident St. Josephs Hospital in Burbank, CA.  His name is Dr. Raymond Schaerf.  He was one of 6 of the best surgeons who was pioneering lead extractions.  So I got two removed and two implanted.  Since that time I have had 4 more implanted because the thin walled cracked and would give me wierd beats.  The last two leads are double walled, thicker and said to be more resilient than the old.  Apparently, I am very hard on leads.  So you might want to ask about lead thickness.  Dr. Schaerf travels around the country teaching surgeons how to do the laser extraction method and implanting using some fancy plotting of the inside of the heart to find the best location for the lead to be implanted.  I agree with someone above that you should try to find a surgeon who has done lots of these procedures successfully.

Look up Dr. Schaerf on the internet.  He's a busy doctor but his office people might be able to recommend someone he has taught his methods to in your area.  For me, I will be going to Burbank for the rest of my life or until "Dr. Ray" retires!!!  

BTW, the dual chamber pacer has saved my life and allowed me to be a husband, a Dad to a son and daughter, to survive a long teaching career, to travel (most) every year, to do lots of things in my retirement years like riding a bike long distances and to reach 70 years of age!  The pacer is VERY important for keeping us going (total heart block) but the leads get the electrons to the muscle.  I was soooooo fortunate that pacer technology came along when it did.  I sure hope I have helped in some way.  

10 pacemakers and 8 leads and 6 leads extracted...I try not to think about it much!

Gary Norgan

Hemet, CA 

Extraction

by barnet38 - 2020-10-23 22:17:23

Hi Annie

I'm going to be having the extraction surgery and new leads placed in December.  My ventricular lead malfunctioned a couple of years ago, and my PM has been operating in unipolar mode since then.  I have also had my current PM for 4 years, but the leads are over 20 years old.  I hope your appointment went well and that you received the information you needed to make a decision to extract or not.

 

Gary - Thanks for sharing your positive experience with lead extraction!  I am also a teacher and enjoy indoor cycling.  I agree that the pacemaker is a blessing!

 

Lead extraction

by Finn - 2020-11-30 13:16:46

I'm had a lead extraction in 2017, originally implanted 2009, so the leads went early. St. Jude / Tendra leads.

it is more difficult than the original procedure, a sheath laser is used to extract the leads since they are imbedded . However they were replaced with MRI safe leads

i was back to work in 2 weeks, my chest did hurt for a couple months, one over night.

hope this helps.

finn 

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Member Quotes

It may be the first time we've felt a normal heart rhythm in a long time, so of course it seems too fast and too strong.