pacemaker fractured wires

I live in Tucson Arizona. My first pacemaker was placed in Oct. 2002. In Feb 2007 my atrial wire fractured. A new pacemaker and new wire were placed at that time. In August 2014 my battery ran out and a new pacemaker was inserted. Now in Feb 2021 my second atrial wire fractured. A doctor I was referred to said he wouldn't take out a fractured lead but rather would add a fourth wire to that vein and also he refused to put in a new pacemaker at that time so I will need to have that done in the next three years. So I'm looking for a new doctor who will give me all my options. If my insurance won't cover it I'll change insurance in December of this year. Looking for help,

Thank You


6 Comments

options

by Tracey_E - 2021-03-10 07:26:18

Is the lead working? It's possible for a lead to be bad but still functional. When that happened to me, they had to turn it up to get the signal through (think running the air conditioner with the window open, the house still cools but the power bill goes up). This kept it going until the battery died so we could take care of both at the same time. And it didn't take long for the battery to die with it turned way up, less than a year. This also gives you time to weigh your options and choose a surgeon. 

Are they sure you even have room for a 4th wire? That would be a lot. They can do an iv with dye in the cath lab to make sure you've got room before going this path. 

I have heard of people getting a new device at the same time they dealt with a bad lead, even if the old one wasn't dead yet. That's subject to your insurance, but I can tell you for sure it's been done. 

From what you've said, it sounds to me like this doctor doesn't deal with this often. I would talk to another doctor, an electrophysiologist that specializes in extraction. There are many more of them out there than there used to be but depending where you live, you may have to travel to get one. If you have to travel, then travel. It will be worth it. You don't want to have two surgeries if you don't have to. You don't want to try to add a new lead only to learn there isn't room. And if there isn't room and you have to extract to make room for the new lead, you absolutely do not want someone doing it who is not highly specialized. 

Multiple fractured leads

by Selwyn - 2021-03-10 12:34:43

Tracey_E gives you some sound advice.

Although my own ventricular lead is damaged, because I am not paced that much using it ( though obviously this is quite an important happening at the time !), my cardiologist is keeping the lead, as the extra current needed to stimulate my heart for the time of pacing is not going to significantly affect battery life.

My consultant told me not to let anyone else extract the lead. He is highly skilled at extracting leads  using laser) .

My own view concerning your troubles is that you should seek another cardiological opinion.  At least here in the UK, we do not have to look around for funding. Best wishes for that activity, it sounds that you will need it. If you have had your PM for seven years, you at least have had 2/3rds of it's life time.  I would have thought a whole new set-up would be of benefit - who wants two surgeries?

 

Extraction

by doublehorn48 - 2021-03-10 13:25:08

I had lead extraction done 4 years ago.  For all my problems my wife finds the most qualified Doctors to keep me rolling merrily along.  The best rated heart hospital in the USA is the Cleveland Clinic in Cleveland, OH.  Dr. Bruce Wilkoff was my Doctor and he's probably done more extractions than anyone.  I live close to Dallas and I'd gladly make the trip once again to Cleveland.

Best of luck,

m. scott

 

four leads

by dwelch - 2021-03-17 23:51:17

I hav e four leads on the same side.  two original (almost 34 years ago) one of those broke (7 years later during the first replacement).  a few years ago I needed to switch to a biventrical three lead pacer.  turns out I had room for a fourth.  had I not had room the plan was to still put it in and then a separate day/procedure remove the unused lead.  I have supposedly "the surgeon" you want to have for this region for extractions, but he also puts pacers and leads in too too.  

I wonder if your surgeon is placing/routing the leads poorly, how they did it when I started suppsedly leads to more broken leads than how they do it today.  

And yes statistically 34 and 27 year old leads are  a good run.  Electrically they are still very good, when switching from one brand to another one lead was so good there was a feedback loop that caused issues that they easily corrected with some settings...

I have lived in that part of the country and understand that docs in general are few and you often have to drive hours to the big city.  I recommend if you can maybe consider a phoenix doc, or at least in some way without pissing off your current one ask why your leads keep breaking...My doc broke mine during the procedure, I was awake for those and remember him saying "oops" but i was drugged enough that I couldnt get the words out "what do you mean oops?!".

The early rule my docs used was new lead you spend the night, if not and it is just a new device you go home the same day.  Apparently on this last one though it was my decision for some reason, so I stayed the night. 

Then there is the insurance side of it and getting the docs to take responsibility for any of these problems would take a lawyer (and pretty much mean you need to find a new doc) so hopefully insurance covers all of this.  good luck.

Wow

by Blondpacer - 2021-03-18 08:42:13

I guess hearing this I hope my leads are ok. I only have 2 since 2002. Just throw another battery in. I go to Deborah Heart and Lung in NJ they put in my first one. My second one I woke up during operation not happy. Go back to experts. 

Potential of 4 leads

by Lisarose - 2021-03-27 14:31:20

Hi Morris, 

I hope some of the previous reply's have been helpful and have given you the info and assurances you seek.

I live in BC, Canada and recently did have two leads extracted. The advise from my surgeon was that new studies and best practise includes to remove any non active leads due to possible future blockage concerns as well to remove them while a person is healthy and able to tolerate this procedure vs waiting until general health is poor thus putting person at higher risk for this surgery.  When you explore surgeon options, look for a surgeon who can complete this procedure using laser lead extraction and have them replace the pacemaker at the same time.  Ie: a complete reset where you won't have to go back in a year or two and be opened up again.

take care,

Lisa

 

 

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