Revision Hell - Leads just wont stay

• by lywest
• 2008-11-01 04:11:16
• Complications
• 1830 views
• 8 comments

Hello all,
Wondering what you guys think of my situation, would like to know if anyone has ever experienced the same and also would welcome suggestions on how to proceed.

44 yr old female – very active, heavy set and very well endowed on top (more on that in a bit)

Please forgive the typo’s and medical misspell’s in advance.

July 8th, 08 I pass out for the second time in a year. This time I went to the ER and after exhaustive studies was diagnosed with Sinal Node Dysfunction Disorder (sick sinus syndrome)

The doc said I needed a PM so I eloquently asked for a 2nd opinion. A second doc confirms that PM implant would be the appropriate course of action. No big deal, outpatient surgery and the whole procedure takes about 30 and most folks go home the same afternoon. Well I figured if it would get me out of the hospital and back up and running we would go for it.

I had the impant surgery on July 10th, 2008 - I suppose a standard implant on the left side, small incision with standard staple closure and was told to come back in 2 weeks for a wound check. I took it easy, no extended arm movements and no lifting of heavy objects.. yada yada yada. Towards the end of the 2nd week I noticed that I just did not feel as good as before. I mentioned this to nurse who was removing my staples but felt like my concerns were dismissed. I was instructed to return in 6 months and I could go back to work when I felt like it.

Over the next 4 weeks I continued to continue work from home (I am lucky that I get to do that) and was getting ready to get back on the road. My job requires a tremendous of travel. I woke up that morning and felt my diaphragm was popping. I got up took a shower and the issue became worse and I decided that something was wrong and went back to the ER. The results showed that my Atrial lead was dislodged and the Ventricle lead was not capturing very well so it was hanging on by a thread so to speak. A lead revision was scheduled for the next morning. I went into surgery and everything seemed to go well until I was having trouble waking up in recovery and then all of sudden I coded. Apparently my A-lead had fallen out and lodged into or near the valve and was causing problems. I was rushed back into emergency surgery and had another lead revision that same day.

2 weeks later I go back for staple removal and the device interrogation does not look good so I go back for a chest x-ray and sure enough my A-Lead is out again. The doc is completely perplexed as he has never had this happen before in his 30 years of practicing. He proceeds to turn off the A-Lead and leaves the bottom only pacing until we can determine what to do next.

I ask for a referral to an EP specialist and schedule an appointment with a different doc at a different facility. The EP is confident that he can fix the issue and it should not be a problem. I schedule the surgery which was the 23rd of October and yesterday I went back for a wound and device check and sure enough the top lead is out and the bottom is almost out also. Again, top lead is turned off but this time the V-lead is not capturing well so it is turned up so high that it is very uncomfortable and popping pretty hard when it paces.

I go back to talk to the Doc first thing Monday morning to talk about a path forward. I frankly do not know what to do at this point and both docs believe that the problem is anatomical in nature ( I have fairly large breast) and they think that the weight simply pulls the leads out. Each time the honestly felt they had left enough slack, I have been so very careful and have worn a bra night and day since July.

So after 3 lead revisions, facing a 4th in 4 months, it is all getting very old and just need to know if other folks have ever had similar issues and if you have recommendations on where I might be able to go to do more research on options.

Thanks….