Lesson Learned !!

As it's been such a whirlwind with my pacemaker changes this past year & being near back to normal I just want to pass on some info. My 4th replacement pacemaker was in 2009 & did a great job until it eroded. As my site had lots of scar tissue & was not taken care of & also no interogation prior to my 5th replacement implant.
Within hours while still hospitalized I noticed my monitor showed HR resting 50 or less. I was told my replacement was just working "fine". I just asumed I had settings of 50-130. A month later I had my interogation by my Medtronic rep. I asked him to change my low setting to 60 as all my previous settings were. He said that's exactly where it's been set.
So about 3 months of HR all over the place my 5th replacement decide again to rotate & erode. Having lost faith & being both my left chest & right chest sites were no longer favorable for another implant I went to Harper University Hospital where a good interogation was done in preparation prior to repalcement to a new site. The interogation showed next to no Atrial sensing indicating a bad lead.
So, in reality my 5th pacemaker was not doing "fine" as I also experienced sleepless nights due to low HRs'.
Upon removal of this PM & leads lab tests showed infection on the tips of these leads. So, the moral is just because one feels great & priority is on problems dealing with erosion, there could also be even more underlying problems.
Now I'm hosting my 6th PM in my abdomin & doing well after undergoing 7 weeks of extensive Vancomycin IV to treat infection.
I also want to mention that I had a number of lab blood work done & none showed any infection in my blood including at the time of removing my PM & leads.
As I don't want to post this to alarm members but also want to encourage being observent. Even now I have no guarantee with antibiotic "overkill" if my heart walls are clean. Also want to mention anyone having questions I'm back online & message me for details if you like !!
DonB

4 Comments

Lab test on lead

by Minnesota - 2013-07-31 02:07:23

Hi Don. Hope you are continuing to do well now with you new placement. I have a question. I am battling an infection. I had CBC and cultures as Zia mentioned and like yours, they came back normal. My doc said that the infection was localized in the PM pocket. It wasn't in my blood so my tests came back normal. But because it didnt culture we dont have any idea what bacteria we are dealing with making it harder to treat. Nevertheless it is serious and being treated with antibiotics. First drug didn't help so now I'm on a new one. If it doesn't work I will need PM and leads removed and new one on right side. My question is - is it standard procedure to test the leads and PM to identify the bacteria? I would sure hope they would do that on mine. It is a mystery how I got the infection. Maybe it would help to at least know what bacteria was found? I don't know. Anyway, You take care. Glad you are back.

Welcome back, Don

by Zia - 2013-07-31 02:07:34

Sounds like you've "been there and back". Sure hope it's going well for you. For the blood work, a question - did it include cultures? If not, the infection would probably not have been noted, although a high white count should have alerted somebody, if you had that. It would show on a regular CBC which you can hardly be hospitalized without getting at least once.

Anyway, no need to play the blame game, just hope they got it right this time.

Sorry Minnesota!!

by donb - 2013-07-31 03:07:24

Hi again, I just got my info corrected from my Cardiac nurse wife (retired). Yes my pocket was infected, where all along I couldn't see how the tips of the leads in my heart showed infection without picking it up from the other end. The infection Gram Negative Staff showed in the culture. I have to also add that I could not get admitted to the hospital until drainage showed. When admitted my pacemaker & leads were removed & cultured. I might also add that in the past I've picked up the hospital bug, C-Diff and the only treatmentI I found was Vancocin an oral intibiotic, very top shelf drug $$$$. I might add in my 81 years of hospital experiences this last one was #20. Also my #1 at a care facility to get my IV's as owning a nurse no longer works with Medicare. As I've been following your "trip of care" I always get reminded of years ago a top
Neurosurgeon told me taking medication orally is like putting a house fire out by hosing water down the chimney.
Hopefully by flooding my whole body with Vanco they managed to kill the bugs.
DonB

Blood Work

by donb - 2013-07-31 03:07:56

Hi Zia, As you said "been there & back" As wife being a cardiac nurse, culture & CBC tests were taken & they showed negative. I didn't mention that my old left chest site still hosted both leads from 1992 & a TEE test showed very slight questional infection at attach points in heart wall.
The old leads could not be pulled as a plastic surgeon stretched the leads at point of entry in vein & cut them short allowing leads lowering into vein. Also on doing removal surgery a groin cath was done & safe removal from heart end of leads was not possible without doing openheart which was higher risk. Hence, 7 weeks of maximum Vancomycin flushing heart walls was the lesser risk. I also had previous Vanco IV with no side effects where I had Cipro & Other antibiotics which resulted with C'Diff a number of times. Thank You Zia for your feedback as I hope others reading can benefit also.
DonB

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