Newbie - Lead Doesn‘t Have Enough Slack?


I got my Biotronik dual-chamber pacemaker on July 20th this year. The scar has healed up fairly well now.

Yesterday I experienced some neck and chest pain, and decided to go to the hospital to be on the safe side. (I felt like there was a "gurgling" sensation as well when my heart would beat, so I panicked a bit.)

They checked me out at the hospital and the pain eventually subsided. They didn't see anything that might be causing the pain, but they did of course check my heart and pacemaker, since the implant was just a few weeks ago.

The doc said that the atrial lead didn't have enough slack, and said I should undergo another surgery to have it readjusted. He said that the pacemaker is still functioning correctly right now, but since I'm young, he believes eventually I will dislodge it if it isn't repositioned.

I am actually visiting family out of town at the moment, so it was a different cardiologist who checked me out this time. He was pretty insistent that if I were his patient he wouldn't leave the lead where it is. I asked him for a copy of the x-rays so I could show my cardiologist at home at our first post-surgery check-up in a few weeks.

I have had a hard time recovering from the surgery so far and would really prefer not to have to reopen the wound and spend even more time trying to heal. I'm also anxious about having another operation because of the possibility of infection or other complications.

Do any of you who have had leads repositioned in the past have any advice for me? Should I just go ahead with the surgery, or does it make sense to wait a few weeks to get a second opinion from my own cardiologist? Is the surgery to reposition a lead shorter/easier than the pacemaker implant surgery? Maybe I'm making too big a deal out of a simple procedure. Thanks again for all your support!


Awww such a worry!

by Lavender - 2022-08-20 17:47:43

You certainly don't need more consternation and choices. Ugh. I would personally get a second opinion from my own cardiologist before doing anything... and you should be able to do this right from where you are if the hospital can relay records to your cardiologist for review. 

However, if it's an extended stay with family AND  there is a good facility nearby with an EP who's well thought of-I might consider letting them have a go at it. 

I'm sure that the last thing you want is more surgery. Perhaps you could get a quick consultation by phone with the doctor who placed these leads-while you're still with family. They would have original xrays and chart notes on the lead placement and could review that. Perhaps the cardiologist who recently saw you could forward the xray copy electronically to your former cardiologist to compare it to the post implant xray. 


by Tracey_E - 2022-08-22 12:59:28

First of all, talk to your own doctor and get their opinion. If the lead is, indeed, in a bad position, it's better to fix it now than years from now. Leads grow into place over the first year. Right now, they're easy to move. I don't know about leads not being long enough, but I know that when the box itself is uncomfortable, they like to let it settle for 6-12 months before making the decision to reposition. I agree with the others, it's odd that it would be too short. Usually they're too long and the extra is coiled behind the box. 

This surgery would be MUCH less complicated than the first and recovery will be much easier. 

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Do feel free to contact the manufacturer of your device. I have found them to be quite helpful when I have had questions and concerns.