And the Count Down Begins

  Finally have a date for my CRT-P placement:May 1.  Yep, only 8 weeks away.  *sigh*  That's soonest available (short of an emergency which to date I'm not).  But I will be very busy during these next 8 weeks still exploring other options. 

I need to get a second opinion from a different system with regards to pocket placement options actual device.  My EP is knowledgeable but really, really, really does not want to do anything other than a traditional subcutaneous pocket placement. (He's a younger guy too).  He's really conserative about potential infections and wants to be as minimally intrusive with cutting into my body as possible. Not a bad perspective.  His infection rate is <1% which is good and I understand where he's coming from.  I tried to make clear what my priorities were with regards to esthetics and potential interference with things like backpacks.  Had a good conversation.  I agreed to let him use his best judgement as to whether it will be subcutaneous or subpec so I could get on the schedule.  Unfortunately in either case i get another scar on my chest that will be even more visible than the collection I already have.  And he is very  aware that I am not pleased with the options presented.

In the meantime I'm trying to get a second opinion appt in a different health care system (Univerity of  Iowa) that claims very good success w/ submammary placements and use of conduction system pacing verses biventricular.  Medicare is  very portable and if I need to travel out-of-state, I'll do so. I don't know if I can get a consult within the next 8 weeks (I hope so), but at least I need to try.  Once the incision is made, it is there for life.  Could I learn to live with it and get past it.  Absolutely.  But it is important that I at least try to rule out the other options tossing about in my mind.

Also, when I asked EP which model Medtronic he'd be using, he looked puzzled and said he believed there was only 1 for CRT-P.  Medtronic website shows 4.  Could three of those be "older" and no longer regularly used?  Just curious if others have thoughts. 

 

4 Comments

soon

by new to pace.... - 2024-03-07 12:04:26

Was just wondering this morning if you were closer to finding a date.  Glad to hear you are .  As to the scar  they closed mine with Surgical Glue.  Unfortunatly found out was allergic to it.  Only itchy bumps as soon as the glue off my body was ok.  Nothing to be seen.

Just remember to  not to overthink this.

new to pace

New to pace

by Andiek11 - 2024-03-07 12:07:44

Oh dear did you just hit the nail on the head.  *lol*  I am the QUEEN of overthinking and with this much lead time before the procedure, I've fallen into that dark hole.

Hi☘️

by Lavender - 2024-03-07 19:31:22

As I have said, my scar is a thin barely visible short white line. My Boston Scientific CRT-P is under skin lying on top of the muscle. No one notices it. 

Conduction system pacing is a technique of pacing that involves implantation of permanent pacing leads along different sites of the cardiac conduction system and includes His bundle pacing and left bundle branch pacing. We do have members with HIS bundle pacing.

I had no idea what brand of pacemaker or model I was getting. No one asked me. I was told after the surgery what they decided upon. I was told that decision is made by the cardiologist and EP. That was fine with me because they know much more than I ever will about pacemakers. 😆

Hello From a Fellow Queen of Overthinking

by SeenBetterDays - 2024-03-08 11:33:07

My husband tells me that if I can find something to worry about then I will. I empathise!

I have had HIs bundle pacing since 2022 and it has really helped me as my ejection fraction was falling due to high volume left ventricular pacing with my initial pacemaker (implanted in 2021).  I had my device placed above the muscle but it is very prominent and I have a hypertrophic scar.  I have a small build so I think it might protrude more because of the lack of tissue to cover the device.  There are pros and cons as regards placement.  I think I might consider submuscular placement next time but know this can be a more painful option with a longer recovery time.  If you are younger then there is the potential for a number of box changes during your lifetime and I have been told that the deeper the placement, the more difficult it can be to access and replace the device.  As usual with medical issues, there are no clear cut answers.  It is really down to what you see as the priorities for you as an individual and what best suits your lifestyle.  I hope you can come to a decision which you feel comfortable with and you can find a good team to look after you.  Keep us updated. Sending you love and best wishes.

Rebecca 

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