Pacemaker change

Hello Everyone,

I am new to the group and would appreciate any advice/comments.

It's time for a PM change and I was given two options. The auxiliary of the subclavian vein currently has two leads, and one of the leads is not functioning as it is supposed to. Option 1 is to place another lead which will be a third lead in the vein which could potentially cause occlusion (blockage) in the future, and Option 2 is to laser extraction of both leads and new leads inserted. This has to be done by a Cardiac Surgeon.

If anyone has faced this choice, I would like to know which option you chose and why (Pros/Cons). If confidentiality is required, private replies are welcome.

In Appreciation,

Val


5 Comments

Broken lead

by JaneJ - 2022-05-06 00:59:29

I had to have a lead extracted a few years ago due to a lead fracture.  The lead I had extracted was only about 4 years old, but I was still extremely nervous.  They advised me that due to my younger age (was 39 at the time) and the possibility of needing additional leads at some point, as well as the risks associated with clogging up the vein with more hardware, to have it extracted.  How long has your lead been in?  Also it's best to go to an institution that does a lot of lead extractions and is very experienced with it.  It gets complicated when you add a bunch of hardware into the sc vein.  I was also a bit nervous about developing svc syndrome, if too much was clogging up the vein.  I'm sorry you have to be faced with this decision, it's so stressful.  I wish you all the best with what you decide to do.

it would help if you filled in your profile

by new to pace.... - 2022-05-06 05:26:44

that way others would know how to help you

been there

by Tracey_E - 2022-05-06 09:22:24

My doctor suggested we extract, but when I told him my reasons for putting that off, he agreed with me. First thing we did was a venogram (iv with dye in the cath lab) to see  how much space I had in my vein. Plenty, so we added the third, capped off the bad one. That was 2010. My original leads were put in in 1994. One of those original leads is still working well, so I'm coming up on 30 years paced and have not yet had an extraction.

My age is why I chose to wait. I'm 55 now, so was mid-40's when the first lead went bad. By putting off extraction, I was hoping to increase the chances of only needing to extract once. If I had to extract next week and got as many  years out of the next set as the current set, that would get me well into my 80's.

Other minor factors, leadless technology is not yet there for those of us who are dependent but perhaps it will be by the time my current leads wear out. Also, extraction is generally not considered high risk, but because of the age of my leads, it will be a riskier surgery for me. My hope is that in the years I put it off, the extraction technology continues to improve, and the surgeons get more experienced so that by the time I need it, it's less risky. It has already come a long way since I made the decision to wait. 

How old are you and how old are your leads? If your leads are new enough that you have minimal scar tissue, taking them out now may be the better choice. 

Downside is I have a dead, capped off lead in there. I've heard people say that's bad but it hasn't caused problems. In the last few months, I've had some very minor swelling in my left arm, most likely due to the leads. I don't know if 3 is making it any worse than 2 would because people with 2 can have the same problem. It's minor enough that my doctor isn't looking into it. I only noticed it because my watch band was getting a little snug. Also when I got my covid vaccines, I had enough swelling and fluid retention on that side that I've been told to get all future vaccines on the other side.

If I could go back and do it again, I'd make the same decision. 

Pacemaker change

by Aberdeen - 2022-05-06 13:46:57

Am I right to assume that your pacemaker has been in place for a number of years? 
I have a CRT pacemaker and my ra and rv lead failed after less than 2 years.

My surgeon said that if at all possible he would remove these leads and replace them as it was better than having a number of leads in place. Fortunately he was able to do so due to the fact that they were less than 2 years old.

It is your decision but I think it would be a good option to have the failed lead replaced.

Pacemaker change

by VE - 2022-05-09 16:09:43

Sincere "Thanks" for each individual response and apologize that I did not provide more personal information earlier. I am a male, 73 years old and had my pacemaker implanted in June 2012, hence it's time for the replacement. My Electrophysiologist has reported that I am not dependent on the pacemaker.

Cleveland Clinic has a "Virtual Second Opinion" and for a fee provide the following: 

- Collect my medical data

- Reinterpretation of scans, tests, reports, etc.

- Expert review by a Cleveland Clinic Specialist.

- Video consultation and written report by the Specialist.

Would like to know if anyone has been through this process and would like to share any thoughts.

With Gratitude,

Val

email: valuedexperience@yahoo.com

 

 

 

 

You know you're wired when...

A thirty-day guarantee is not good enough.

Member Quotes

At age 20, I will be getting a pacemaker in few weeks along with an SA node ablation. This opportunity may change a five year prognosis into a normal life span! I look forward to being a little old lady with a wicked cane!