Movement of lead

So at my 3 year pacerversary I started having transient loss of conduction.  So I would vpace. That was in AAIRD<=>DDDR MODE MVP ON.

So they switched me to DDDR MODE MVP OFF

then I was getting a lot of vpacing, at a higher rate but not my upper limit, 3 months ago it started getting faster. So after a year of complaints it was PMT. I was always curious though, if nothing was wrong with my av node, why the vpacing. So they lowered the minimum on my pvarp from 250 to 280and then i started having shortness of breath. EP says an illness is causing it. So my pcp ordered an xray and on the report it's noted that the right atrial appendage lead is now projected en face. All my slack is gone for my lead. Whether standing or laying, the slack is gone. Anyways could this be causing a problem? 

 

1 Comments

Your SOB

by Good Dog - 2022-09-04 20:48:01

I am sorry, but I do not think that I can help you. I hope I am wrong, but I am thinking that it may be unlikely anyone else here can help you. The history you provided is lacking details including a more thorough chronology for the events. Additionally, there could be a multitude of reasons for your SOB. I just have no clue. So I would only be guessing, and that can't be much help! The fact that your PM dropped and the slack in your leads being removed does not in itself indicate there is a problem. It is certainly possible, but unlikely that it would dislodge a lead that has been in place for three years. You indicated that from an xray it was determined it is facing forward, but did not indicate how that relates to its original and/or proper placement. I have exactly that same situation with my PM dropping that took-up all the slack in my leads, and I have suffered no ill effects from it. However, I would think that the MVP setting being switched off could result in unecessary V-pacing and shortness of breath, but that is just a guess. That is something that should be obvious on your PM report or an EKG. Have you had either since they switched your mode to straight DDDR? I would suggest you get to the Doc and explain your symptoms with the chronology of them. He is likely the only one that can help. If he doesn't, then maybe a second opinion is in order. Perhps the ER if necessary. You need to get to the bottom of it asap though. These kind of problems always seem to occur on weekends. Now that is something I can relate to! I am sorry that I cannot be more helpful.

In any case, I wish you the very best and hope you can get to the bottom of this quickly. Keep trying. Just do not give-up!

Sincerely,

Dave

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