Max Leads

Perhaps a previous Poll will be of interest

by Gemita - 2023-11-01 09:49:27

Hello Cat, I am glad you have opened this question up again and have not “restricted” your post only to those who have had “extraction” of leads.  You will have a much better chance of getting more responses now and a better idea of what type of device and number of leads we all have.

Looking at a past Poll I see we had one on “What type of device do you have”?  The period of time this covered is difficult to assess and I will try to find out and report back if I am able.  Of course, we could always do a new Poll, to include leadless pacemakers as well and then perhaps a separate Poll on Lead Extractions, to get a more up to date idea of where we currently are.

Anyway, from our earlier Poll, whenever it was conducted and for whatever period of time, there were 2,947 member responses.  The results were as follows:-

Single lead pacemaker 8%

Dual lead pacemkaer 62%

CRT 3%

CRT-D 9%

ICD 17%

At least the above results gives an indication of the number of leads and pacing systems members had/have.  I don't suppose the main results have greatly changed, although I suspect there are a few more CRT or CRT-D members now. 

I will report my device number of leads now in a separate comment.  I will get my husband to do so too

I have 3 leads

by Good Dog - 2023-11-01 10:05:01

I have one original lead (1987) in my atrium and one active right ventricular lead (1995). The original lead in my RV was recalled a year after it was implanted. So during the next generator change in 1995 it was capped and left in place while a new RV lead was implanted at that time.

Summary:

1 atrial lead 38 years old as of Jan 13, 2024.

1 Ventricular lead 30 years old

1 abandoned venricular lead 38 years old as of Jan 13, 2024 (capped and abandoned in 1995).

So 3 leads total and no extractions.

I have 1 lead

by michael.p - 2023-11-01 10:41:44

Hello I am 85 and in 2018 I had a single lead Medtronic pacemaker implanted with the lead positioned in my Right Ventricle (septum area).  I still have a fairly long battery life to look forward to and my single lead is healthy and working well, so no extractions or complications to report.  

I am pacing around 80% in my Right Ventricle now (as reported 5 months ago).  I do have signs of right sided heart failure but I am still fairly mobile.  It is difficult to know whether a single lead in the right ventricle has caused a worsening of my right sided heart failure which was already present at the time of my implant due to another health condition (pulmonary hypertension). 

The pacemaker has helped me to manage my arrhythmias and to take high doses of medication without lowering my heart rate to dangerously low levels.  Prior to my pacemaker I had episodes of loss of consciousness.  Clearly at my age, having a fall could lead to serious harm, so I feel protected knowing that my pacemaker is working well for me and keeping my heart rate steady. 

I hope I have answered your questions.

Good Dog

by piglet22 - 2023-11-01 11:20:12

I liked the "capped off and abandoned"

Sounds more like a Texas oil well.

Yes, with coaxial leads like PM leads, there will be an outer sheath which shields the inner signal leads from interference.

These leads or at least larger diameter cables have connectors called BNC or TNC. B is for bayonet and C is for threaded. Obviously they aren't bayonet.

I suspect that the PM leads have a very complex connector that will be made to be waterproof. Coaxial leads can be made down to incredibly small sizes and I work with leads a lot less than 1-mm diameter. UFL is a typical connector and I have to work under a magnifier just to connect them.

As well as capping the lead to protect it from corrosion etc., it's quite likely that the cap will short out the leads to prevent spurious signals being generated.

I have two leads

by Gemita - 2023-11-01 11:46:25

Cat, I had a dual lead Medtronic pacemaker implanted (also like my husband in 2018) for syncope, pausing and tachycardia/bradycardia syndrome.  So far I have had no problems with my leads, although due to my high % of atrial pacing, mode switching and other frequent changes during my atrial tachy arrhythmias, my battery is running down and will not last as long as my husband’s single lead device which has a “quieter” time!  

I have to say with my dual lead pacemaker I have had a great deal of success in controlling my rhythm disturbances, and I can only speak highly of my device, settings and mode of action.  My quality of life has improved immensely.  I am paced almost 100% in the right atrium, with less than 2% right ventricle (septum) pacing.  Atrial pacing feels very natural.  I am fairly active, although sadly I do not exercise as vigorously as I would like due to my arrhythmias.

Leadless pacing is a rapidly growing field but we still need years of trialling this product to catch up with what we know about lead technology.  We do have several members here with leadless pacemakers if you want to search under “Q”, top right

piglet22

by Good Dog - 2023-11-01 11:51:01

Thanks for the info! Interesting! My EP at the Cleveland Clinic has seen a lot of different leads from different manufacturers. He rattled-off a bunch of numbers and told me that mine are among the most rugged he's worked with. I guess that should be obvious given their age

With my old rusted leads (lol), the Medtronic guy told me that I would not believe what they have to do to connect it to the new generator. Obviously, they've changed the connector style (maybe multiple times) since 1987. So I am thinkin that maybe they use electrical tape and bailing wire? Or maybe they have to break out the soldering gun in the operating room.............

I have 3 leads

by Julros - 2023-11-01 16:47:09

I have a CRT-D, so I have an RA, and RV and an LV lead. I was first implanted with a CRT-P 3 years ago. Subsequently I was advised to upgrade to a defibrillator. I was given the choice to cap off and leave the original RV lead, or extract it. I chose to have it extracted because: 

1) it had only been in place for 2 years

2) having an additional lead cross my tricuspid valve increases the risk of tricuspid regurd

3) Leaving a capped lead in place would prevent any future MRIs, and I am fairly young (65 at the time) and I might need one in the future. 

4) I was referred to an EP who is hightly experienced and does several a year. 

3

by USMC-Pacer - 2023-11-02 02:23:45

I went from 2 leads to 3 earlier this year. They extracted 2 leads (1 damaged, both entangled) that were nearly 11 years old and implanted 3 new leads. No complications :)

2 Leads

by FG - 2023-11-02 19:34:35

1 at Right Atrium

1 at Septum for LBB pacing