Impedance increasing

My heart failure doctor seemed concerned that my impedence was continuing to increase.  My fluid level continues to stay the same--top of the normal range.

She said she was going to have to do some research and check with my EP.  Does anybody have any ideas?  There was a concern last year with my former EP that I had a lead that had variable voltage and a lengthy phone call with Medtronic determined it may be failing.  It was never addressed after that appt and I assume the lead tested ok when my device was changed 6 months ago.  

I am 100% paced in all 3 leads.  

Karen


2 Comments

Increase in impedance - what does it mean?

by Gemita - 2022-07-30 06:39:41

Karen, I wish I could help but this is clearly a complex problem for your doctors and Medtronic technicians to deal with and to try to reassure you. I see from your history the difficulties you have had with your devices and leads, the extensive testing you have had for both your heart condition and pacemaker system.  Your message therefore causes concern that your doctors are still no nearer to providing reassurance that your device is working as it should and is “reliably” supporting your heart condition.  

Have a look at an old Pacemaker Club thread on increase in lead impedance.  Increased impedance clearly doesn’t always point to a lead failure. (Particularly scroll down and read ElectricFrank’s comment).  Lead impedance testing can be an insenstive diagnostic tool, so please don’t panic.  They may just decide to wait, watch and do nothing for the moment as valued members commented in this old thread:-

https://www.pacemakerclub.com/message/2069/failing-lead 

and also see your own earlier thread:-

https://www.pacemakerclub.com/message/40366

For peace of mind, you could ask whether your steady increase in impedance could affect the operation of your defibrillator and pacing in general?  If I am not mistaken you changed your EP and are with a new team, so you should be getting a different opinion and hopefully a better one too?   

From what I have read and see from the following technical article, impedance can be difficult to assess.  The article is long but you may care to extract relevant bits that might help to answer some of your questions and help you to discuss this matter more fully with your doctors.  

https://www.ahajournals.org/doi/10.1161/CIRCEP.119.008092

Early identification of any lead-related abnormality is important for you because you are heavily paced with each lead and depend on your pacing system to keep you safe.  Whereas sudden changes in impedances can reflect lead fracture or isolation defects, gradually increasing impedances can occur because of calcification, scarring.   You are clearly being closely monitored Karen to pick up any dangerous changes, so you should be reassured that nothing will be missed.  As always, I send my best wishes to you and hope all will be well

Thank you Gemita

by islandgirl - 2022-07-31 11:00:29

Gemita - Thank you for your reply and for the reference to the AHA journal site.  I had read past PM club posts, and AgentX86 has responded most recently to another impedence question, which also helped broaden my knowledge.  

I have great confidence in my 'new team'.  I will see the HF dr. in early September.

Stay well and best wishes to you!

Karen

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