After 1 month of my surgery

Leads

by AgentX86 - 2023-05-20 10:23:28

Leads could go tomorrow but the norm is about twenty years.  Extraction is getting less problematic each year.  It's still not fall off a log easy but it's done every day but it still should be done by a specialist in the procedure.

In twenty years it'll be done in the local drug store by AI  (if we're still needed by said AI).

Leads

by piglet22 - 2023-05-20 10:46:18

I'm on PM number two and on the original leads (Medtronic dual) after 18-years.

I'm not sure I would be too keen on leadless. Call me old fashioned, but I quite like plugs and sockets and something to grab. It's the worry about something going out with the dishwater.

I requested some chest X-ray copies, something the NHS can do, to have a look at the two different PMs.

What I did notice was that both have a loop where there wasn't one before. The loops appear to be outside the heart chambers. I'm talking 2 or 3 cm diameter loops.

At least they are loops and not kinks. Most cables, especially high impedance stuff like PM leads, do not like being kinked and even for computer cable like CAT5e (Ethernet) the manufacturers will specify a minimum bend radius.

I don't know if it happened at replacement or has developed since.

Loops?

by AgentX86 - 2023-05-20 15:27:06

Loops just outside the "heart chambers" doesn't sound right to me.  The leads enter the subclavian vein under the collar bone and continue down through the vena cava into the RA.  There shouldn't be loops inside the veins.  I would think they'd be perfect places for clots to form.

The leads have loops, usually just behind the pacemaker can, needed to allow for PM movement as the shoulder moves and as someplace to shove the excess wire.

Nicely said AgentX86!!

by Baban - 2023-05-20 15:28:55

I think that pacemakers are going to be much more smaller and the leads are also going to be very less problematic. Atleast we can hope for !! 

Thanks Piglet22 !!!

by Baban - 2023-05-20 15:37:37

Thank you for your positive comment. I have not seen my x Ray so i can't provide much on that. I am also a little afraid to see my xray because I know how my chest x rays actually looked before the surgery. I won't be able the handle the xray which will show me the pacemaker actually!! I know it's funny but that's how it is.. I am still afraid, nervous, not confident at all about my future. I am still trying to recover from the mental trauma i suffered when i first came to know that i have to go for a pacemaker surgery! 

AgentX86

by piglet22 - 2023-05-21 12:19:33

I've just taken a second look at the x-rays.

I can see the loops behind the first and second pacemaker (first implant and replacement).

The heart area is quite fuzzy, but there is definitely one tight loop in the ventricle lead about 7-cm from the tip of the lead, so I can't say if it's in the vein or not.

I did a lot of work with high impedance electrodes like pH electrodes and one thing you would always try to avoid is any loop before it got to the buffer amplifier. Just flexing the coax cable caused a lot of noise.

It's been there 18 years so I'm not too worried.

At Present, Dual-chamber Pacing Can't Be Done with a Leadless PM

by JiminyC - 2023-05-25 20:52:15

I got a dual-chamber PM (Medtronic Azure) in April. When advised that I needed pacing, I had hoped to get a Medtronic Micra leadless PM, but was informed that leadless PMs were not a good solution for sick sinus syndrome as they pace only in the right ventricle, and dual chamber pacing is the recommended treatment for SSS. My EP said if I was adament about a leadless PM, he could implant one and pace me in VVI mode, but he didn't recommend it as it could lead to other complications. Hence, I had to abandon my hope of getting the Micra. That being said, PM technology seems to be advancing rapidly, so it's possible that leadless PM's with dual chamber capability will be available at some point in the not too distant future.