New lead

Hi All well not far off now it seems like a eternity since my lead went bad and developed pacemaker syndrome, it's been a tough ride.

Anyway booked in on 25th November for new lead, received a copy of a letter to my "GP" from my surgeon saying the lead will be capped and buried. I haven't seen my Dr to discuss this just a 2 min conversation over the phone that he need to replace the top lead, I am over the moon to get it done as I feel very ill but want to know where the lead is normally buried has anyone experienced any later problems. My old lead is 23years old so I am thinking that's why he isn't attempting to remove it.

I will be having a pre op next week and want to know what you all feel from your own experience so I can pre think my conversation with the Dr, I am trying to take more of a active role in dissisions as in the past I tended to feel Dr knows best. 

Ta all

4 Comments

There's at least one contributor here with a capped lead

by crustyg - 2020-11-14 11:50:29

Hi Maureen:

Glad to hear that you have a date for the new lead.  AFAIK, the capped lead should sit nicely in the PM pocket, and they would spend a little time ensuring that it does so, as otherwise it might erode through the skin.

Best wishes.

Capped lead

by AgentX86 - 2020-11-14 13:09:06

Abandoning and capping a leat is simpler and safer than removing a lead but it generally precludes you from having an MRI somewhere down the road.

I would ask . . .

by Gemita - 2020-11-14 14:09:23

Hello Maureen,

I am so happy you have got a date for the atrial lead implant.  That must be such a relief for you.

Capping and burying the old redundant lead I would imagine basically means, (after capping) leaving the old lead where it is and then either feeding the new atrial lead next to it in the same vein if there is room and if the vein is healthy, or finding a new vein.  You could ask your EP the following questions:

Question:  Could you please explain how you will deal with the redundant lead.  How is this capped and prepared for abandonment?  Will the redundant lead be left where it is presently, once capping has been done?

Question:  Will the new atrial lead be placed next to my redundant lead in the same vein?  If not, where do you intend to place it? 

Question:  Why have you decided not to explant the redundant lead? 

I wonder why your EP has decided not to remove your old 23 year old lead?  Perhaps he doesn't have the expertise or feels the risks are too high and not warranted.  Hopefully with the atrial lead in place, you will feel so much better and can forget all about your buried, capped lead.  Adding an additional lead without explanting the redundant one should be safer in terms of any immediate infection/complication risk of explantation, although what the long term future holds with an abandoned lead is less clear. 

Maureen:  the link below gives a good description of how they cap and secure the redundant lead and gives additional info which might be helpful for your pre op meeting with your doctors.  It is quite complex, isn't it and I can imagine some wouldn't want to know about any of this but we are tough cookies!!  The article is out of date but still helpful I think

https://www.ahajournals.org/doi/full/10.1161/circep.110.952242

 

capped lead

by Tracey_E - 2020-11-16 11:10:09

I have a capped old lead. They don't actually bury it, they just snip it off and cap it. Surgery was no different than any other device replacement, only difference is new lead means arm movement restrictions just like when we got the first one. My xray is somewhere in the gallery, you can see the cap. My system looks a bit like a bowl of spaghetti with one big meatball lol. My first 4 were submammary and they ran the new lead from a different vein so I have leads all over the place. 

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