What to expect with battery and lead change

Their experience is key

by crustyg - 2021-01-27 10:14:56

There's at least one contributor here who has just gone through an atrial lead change, with beneficial results.

The key question for you to ask them, is 'How many lead changes do you perform each year?'  If the answer is less than 100, you really want to try and find somewhere more experienced, as this can be tricky.

There are quite a few contributors here who have had a lead change, and their experience has generally been good in specialist centers.  PM box/battery change - piece of cake!

I hope it goes well for you: I would hate to lose my atrial lead - also 100% paced.

Lead replacement

by AgentX86 - 2021-01-27 11:06:31

I lost my atrial lead.  Oh, wait, I never had one.  ;-)

What Crusty said is crucial.  It's essential that you go to someone who is very experienced at removing leads.  I'd suggest a large teaching hospital, or even be more selective, if insurance allows, even if that meant traveling.  It would be a short (in terms of time) trip.  I'd go to someone who specializes in removing leads.  It is a tricky procedure but has gotten a lot more common as tools and techniques have been developed.  While the operation is much safer than it was, even a decade ago, I'd still want to go to the best. 

Again, as Crusty said, ask how many such procedures has your doctor done and about his record.  It is important.

how are they doing it?

by Tracey_E - 2021-01-27 14:23:05

Are they extracting or just adding a new one? I had a new one added when one went bad. It was the same as the first placement, they went in the same place and threaded a new lead in the vein. Easy, peasy. They'll have you on a temporary or external pacer during the surgery so your heart rate stays steady.

Extraction is more involved. I have not yet had extraction so no firsthand experience to share. 

Lead extraction

by barnet38 - 2021-01-28 19:37:34

I have a pacemaker due to congenital complete heart block, and my first device was implanted in 1998.  I had a lead change and battery replacement at a large teaching hospital in December.  My highly qualified EP is considered to be a specialist in lead extraction at this hospital.  My RV lead had been in place for over 20 years, but had been fractured and needed to be replaced.  I had to decide between extracting the malfunctioning lead or capping it off and placing a new lead.  I chose extraction because I am young (39) and have no other health conditions.

My EP used a laser tipped sheath to separate the lead from the walls of my vein.  I was under general anesthesia during the procedure.  The lead broke approximately 2/3 of the way into the extraction, but he was able to remove the remaining portion of wire by approaching it from the femoral vein.  I am slender, so this caused some bruising in the left groin area.  After the surgery, I had to lay flat for 4-5 hours due to the groin incisions, and had to stay in the hospital for one night.  

The recovery was a little longer than a normal battery replacement.  I did a lot of relaxing for the first few days because I was having trouble with the groin incision on the left side.  My throat was sore for a few days due to the breathing tube that had been in place during the surgery.  However, I started to feel much better about 1.5 weeks after the surgery, started light cycling shortly after that, and feel 100% better (and am back to my regular Peloton workouts) now.
 

Groin incisions

by AgentX86 - 2021-01-28 21:44:43

I've had them go in through the femoral vein a number of times for ablations and once through the femoral artery for a carotid angiogram. Laying flat for hours sure is the pits.  After being pumped full of fluids, then having to lay the back for hours, it's hard to know which hurts more, the back or the bladder. 

I didn't have any trouble with bruising and wasn't sore.  I'm glad I wasn't intubated.  I didn't like that a bit, the one time I was.

Lead extraction

by Finn - 2021-02-02 00:37:55

I also had lead extraction using a sheath laser by a very experienced heart surgeon who does many each year.  I was cut in the in the groin but not sure if they had to use that entrance. Also a thoracic surgeon is on stand by, just in case.

The leads (Tendril)were only 8 years old but were making noise . The new ones are MRI compatible .

recovery was much more difficult than a battery change , chest pain , some fluid , pericardial efussion .