New leads

Policies vary

by crustyg - 2020-10-31 13:14:06

Hi Maureen: it seems to be about 50-50. Some EP-docs keep all of their new implants+leads in for one night, others do all of their new PMs and leads as day cases.

My box and two leads: early AM op, PM setup, CXR, home by 14:00 same day.

HTH.

My thoughts and experience

by Gemita - 2020-10-31 14:40:08

Maureen,

Hello, have you spoken to your team?  In view of your difficulties so far, my gut feeling is that they will keep you in at least for one night to make sure that all will go well and only discharge you when they are happy that any pacing adjustments with the new lead is working for you.

I think too that until they go in and see how the vein looks and have a good look around, they won't know what they are dealing with, whether there is room to accommodate the extra lead together with the redundant lead, whether the vein is healthy and so on.  If placement in the same vein is not possible, they will need to find a new position to accommodate the lead.  There are several things to consider and the procedure may not be quite as straightforward as having a new implant, for the first time in a particular vein.

I was kept in overnight after my dual chamber pacemaker implant because my arrhythmias were going crazy following implant and I was too unstable to leave hospital.  But even without this complication, my team told me that it was their policy to keep patients in overnight to monitor them and then to have a full pacemaker check/data download the following morning and to make any pacing adjustments at this time.  I also had a chest X-ray before I was allowed home.  

When do you hope to have your procedure?  I wish you all the very best of luck with the new lead.

I did

by Tracey_E - 2020-11-01 11:25:29

When I got a new lead, they kept me overnight. They like to test the lead the next day and make sure it's still in the right spot before we go home, same as the first leads. 

thats what I do

by dwelch - 2020-11-02 11:15:27

My first doc 20-30 years ago that was his rule, new lead spend the night, my first replacement he broke the lead so I got another and spent the night.  Recently (decades later, new docs) I got a third lead (well fourth in my body) to switch to a biventrical, and I did talk to them and was under the impression it was overnight.  But after I had been placed in my room for the night some youngun with his face in his phone, asked if I wanted to go home as if it was my call, I wanted to then talk to the doc, he said the doc said it was okay either way.  Very sketchy, I chose to stay the night.  As with any first night it sucked, no comfort, no sleep, but I did get antibiotics a couple times over the night and that I wouldnt have had at home.  And then an interrogation in the morning that I wouldnt have had either.

So as pointed out by others it is not a hard and fast rule, hospital, doc or docs practice, insurance all might poke their fingers into this.  You need to just ask them.  And hope that that answer is what happens that day in case you planned on one situation.