Artifact... fracture?

Lead fracture

by AgentX86 - 2024-04-30 00:58:47

Your cardiologist is right. There is nothing to be worried about.  Because you're paced 99% in your ventricles, it doesn't mean that if that lead fails completely, you do to. 

Since it appears that you have a complete heart block (99% pacing in the ventricles). Given that, you would go back to where you were before you got your pacemaker. It wouldn't be an emergency but would be taken care of quickly. However, with just a noisy lead, there is only a small chance of this.

The tighness in your chest is undoubtably anxiety. If your doctor told you to see him in a year, he's certainly not worried about it.  There is no need for you to worry about it either.  Enjoy your kid and put this out of your mind (easily said, I know).

Leads may have an average life of 15 years but, by itself, that doesn't mean much.  Some, here, have had theirs fail within a year, others thirty years. That's an average of fifteen. 😁

Second opinion

by JaneJ - 2024-04-30 02:28:39

It's good the fracture is not in your ventricular lead, as that would be a bit more urgent and serious matter.  But I agree with you and would want this to be taken more seriously than your dr is taking it.  In my opinion, it couldn't hurt to have a second opinion.  I had a similar situation to yours several years ago, but the fracture was in my ventricular lead.  I also have complete heart block and I'm paced 100% in the atria. My dr did not move quickly with me, when I was dealing with the lead fracture and was nonchalant about it also.  I am an RN, with a masters degree and my husband is a physician and he still didn't take me seriously.  This could of cost me my life, as we found out when we got a second opinion, that the noise from the ventricular lead was interfering with the atrial lead and I was literally having periods of no heartbeat.  Our second opinion got us in pretty darn quick after seeing this.  Thankfully my old dr retired pretty quickly (he sure needed to) not that I would ever set foot in his office again.  It's no joke, you have to advocate or bring some one with you to advocate for you in the medical system today.  It's overwhelming when your in the office having your tests done, and they're rushing things because they have so many patients.  It's good to have another person with you, if you are able to.  Do you know if your impedance measurements have changed on the suspected fractured lead?    I hope you are able to get a second opinion and find out exactly what the problem is with your lead.  Take care!

Vicious Circle

by SeenBetterDays - 2024-04-30 06:21:19

Hi JL

I agree that a second opinion might be worthwhile. If nothing else it will help to put your mind at rest as the anxiety you are feeling could well keep emerging as physical chest pain and tightness which will cloud the picture of what is truly going on.  More worry creates more symptoms and so the circle is perpetuated.  I think that sometimes doctors can be a little too blase when they talk to patients who naturally feel concerned about any issues which may be arising with their pacemakers.  They see so many patients and what to them may seem fairly inconsequential is certainly not for the person who is losing sleep and imagining future scenarios. At least a second consultation would allow you to ask all the questions you didn't get the chance to ask first time round and you can go in prepared.  Hope you are able to get some answers which put your mind at ease.

anxiety

by Tracey_E - 2024-04-30 12:15:41

It's easy for our brains to run away with worst case scenarios but try to logically look at the facts. 

Older leads with noise is very common. Even if it turns out to be a fracture, it can easily continue pacing normally for years. They don't suddenly die when they wear out, they give lots of warning first and they can often program around it. They will most likely wait to deal with it when you get your next replacement. 

I had one that was fractured, my ventricular lead which I pace with every beat, for more than 5 years before we fixed it. Eventually they had to turn the juice up enough to get the signal through that it depleted the battery, then we fixed it when I got the new battery. I was never in any danger, it did its job right up until it was replaced.

The easiest way to see if the lead is working is to check your pulse. If it's not pacing, your rate will drop to what it was before you were paced. On the rare chance this happens, you'll just feel like you did before you were paced. Hospitals and even ambulances are equipped for emergency pacing, if necessary. But this is highly unlikely! What is much more likely is it will feel exactly the same right up until it's replaced. 

When it's time to replace, they can extract the existing leads with a special laser and start fresh, or cap off the bad one and add a new one. 

Please try not to stress over this. It's very common and highly likely they'll just keep an eye on it and program around it as necessary until your next replacement. 

🪻🌷

by Lavender - 2024-04-30 15:15:20

You said, "He did not seem concerned. Said he would see me in a year."

Do you trust him? My cardiologist said that to me about my suboptimally placed lead. If I didn't trust him, I would have gotten a second opinion. However, he's the guy others seek when they need a second opinion-so I trust him. 
I understand your concern. Why can't things just go smoothly for years and not have any worries?  😓