Weird but brief complication of leg pain after PM procedure

This week is my 2-year anniversary of receiving a St. Jude PM, am finally taking the plunge and posting after 2 years of lurking.

The procedure went fine 2 years ago, no complications with anaestheia or anything.  I was sent home the next day, and felt OK the rest of that day.  The next day I could hardly walk.  I could sit down and get up out of a chair all right, but when I tried to take a step forward, had extreme pain at the very tops of my legs, like the muscles wouldn't work right.  Only there, nowhere else.  Wished I had a walker/zimmer to lean on.  The pain lasted the rest of that day.  It was the weekend, of course, and so couldn't call doctor and didn't seem serious enough for ER visit, and that wasn't named in the list of complications to look out for in the documents they gave me to take home.

The following day the pain was gone and I haven't had it since.  None of the doctors I have asked about this have known what might have caused it.  All I can think of is that I laid without moving, in one position (partially recllined) in the hospital bed for 12+ hours, because of having a transvenous pacing in my neck until I could get the permanent PM, and I was afraid to dislodge something.  I believe they put the catheter in my arm, not my groin, during the procedure. There's more to the whole story but didn't want my first post to be too long.

Anyone on the list have any ideas what would cause temporary leg pain?  Thanks.


temporary pain

by new to pace.... - 2023-08-06 17:06:50

It is gone no need to worry about it now.

new to pace

Happy two years anniversary

by Gemita - 2023-08-07 05:36:18

Lillian, we want to encourage you to post again and for you to have confidence to do so, but as new to pace says, the pain has gone now, so I am unclear why you are still wanting to know about this?  I am not sure that getting an answer now is going to help you to move forward, unless there is more that you wish to share?

During catheter access for another procedure, they did go through my femoral artery/femoral vein and I do remember how painful the femoral artery access site was and that I had pulsations and pain in the area intermittently for months due to the trauma.  Some 5 years later it has settled but I won’t be in a hurry to repeat the procedure.

It is hard to know what happened to you two years ago and what triggered the pain in both your legs.  It could have been referred pain from your pacemaker/lead placement;  a temporary blood flow problem to that area;   muscle/nerve pain caused by anaesthetics used or even stress related pain from the trauma of having an implant and it is a trauma for some of us . . . but the important thing is that you are now pain free and showing absolutely no signs of an ongoing problem. 

Do you have easy access to your health records?  You could try asking whether they accessed your femoral site during implant, or get a copy of your implant discharge papers/notes to look for yourself for additional implant information.

But to the present, it would be nice if you could let us know how you are doing with your pacemaker?  Happy two years anniversary Lillian and I hope you will be happy to share your pacemaker experience with us all.

Leg pain?

by AgentX86 - 2023-08-07 10:19:09

Did you change any drugs. Lisinopril will do that (incredible pain) to my arms/shoulders.  Is there a chance you had a mild case of covid?  It doesn't sound right.  Even though it's gone, if I thought it could be tracked down, I would try. I would still make sure that it got into your medical record, in case it comes back down the road.

Weird but brief complication of leg pain after PM procedure

by Lillian S. - 2023-08-07 15:22:17

To follow up on comments:

I was not on any drugs at all prior to procedure.  I had tested negative for covid the day before via a rapid test at work, but when they were working me up in the ER, they said I tested positive there.  Causing both me and the doctor to say WHAT??? because I had already had covid once (mild, luckily) 5 months before, after being fully vaxed.  Had no symptoms this time.  Being positive led to me being isolated in the hospital (it got me a single room at least) and also placing me at the end of the queue for the PM procedure for the day, because they would have to thoroughly clean the facility after a Covid patient had been through.

I am still wanting to know what caused the leg pain two years on, because when I go to have the battery changed eventually, I want to know whether it's going to be a complication again next time. I'm not dwelling on it, mind you, I'm mainly curious why it happened, no doctor can tell me.  I thought maybe it had happened to someone else on the forum.

From what I can make out from the paperwork they gave me, "femoral" was not mentioned at all but "axillary" was, so I take that to mean they didn't go through the groin for a catheter, used the arm instead. So having leg pain afterwards doesn't make sense.

Vein access

by AgentX86 - 2023-08-07 22:39:00

There is no need to go into the femoral (femor, thigh) vein for a pacemaker.  The femoral vein is used for ablations but not for pacemakers.  Pacemaker leads are usually threadded through the auxillary vein , under the collar bone, into the vena cava and into the heart.

Right.  It doesn't explain the leg pain but it's possible that covid could.

I am surprised they went ahead with an elective procedure in the presence of Covid

by Gemita - 2023-08-08 01:03:42

Lillian, Thank you for your additional comments.  While the femoral vein area is not generally used for pacemaker implant access, it can be used if they find upper extremity vascular access problems which is why I mentioned it.  

When you go back for a battery change, it should not be the same invasive procedure, since your leads will probably still be working and can be left in place.  All they do apparently, is open the pocket, detach your old device from the leads which they leave in place.  They will then re-attach the leads to the new device and close the pocket.  Everyone who has had a battery/device change has said how simple the replacement procedure is, far less invasive than the original procedure.

I am surprised that even though you were prepped and ready for your implant procedure, on finding you were positive for Covid, they decided to go ahead with surgery?  Was your pacemaker surgery an emergency?  For elective or planned surgery, a delay of seven weeks after a Covid infection is recommended, including for people who are otherwise asymptomatic (but have had a positive test).  

I hope in the very least they “recorded” on your discharge papers that you had had a Covid infection at that time?   I agree with AgentX86, Covid could well provide some answers for your leg pain symptoms

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At age 20, I will be getting a pacemaker in few weeks along with an SA node ablation. This opportunity may change a five year prognosis into a normal life span! I look forward to being a little old lady with a wicked cane!