Ventrical Impedance

Happy New Year everyone. I have had the same lead for 22 years - so all my pacemaker life.... Battery is almost run out so plans are underway. My question to those of you with older leads is - my impedance is around 220-240 - basically it was 250-260 for almost 8 years! Since I am not too old (36) - I am debating staying with the one that is there - it is too old to extract as opposed to pushing a new one in there if possible.

Any thoughts and/or experiences? Would love some insight from patients as opposed to doctors.

I have one that says no go - and 2 that say keep the one that is there now.....

thanks so much.

5 Comments

Decisions, Decisions

by SMITTY - 2011-01-04 05:01:43

Hello Montreal Girl,

Of course, as you know, you should ask your doctor what he thinks and why.

But if you look strictly at numbers, I would say your leads do not need to be replaced. I looked at the specs on impedance for my leads and I think the number for mine are standard. The info shows a maximum impedance of 4,000 and a minimum impedance of 200. Now I'm guessing here but I think the lower the number the better which says an impedance close to the 200 is what you expect for new leads. If I am correct, your leads are close to new condition so far as impedance is concerned. However, there are other things to consider, such as condition of the leads including insulation after 22 years and other things I don't even know about, I'm sure. I do think that if your's have been in place for 22 years, they will not get any more difficult to extract with a few more years, so I would consider that to be a factor in the decision.

When it is all said and done I think you have a lot of questions that only your doctor can answer.

Good luck,

Smitty

my experience

by Tracey_E - 2011-01-04 07:01:34

I don't know what the numbers were, but one of my leads jumped up about 5 year ago. Because the impedance was up, they had to turn it up higher to get the signal through so the battery didn't last as long but it was working right until it was replaced. Picture the window open but the a/c running- the house cools buty our power bill is high. Since it was working and I'm relatively young like you, I chose to eek out every last drop of life it had in it! It got worse last year so I had it replaced when the newest battery died after only 2 yrs. Thinking long term like you, I wanted to fit another in there and put off extracting if possible. We did a venogram, just an iv with contrast, that showed that I did have room to fit another lead so that's what we did. If it had not fit, I would have had to extract.

I'm no expert, this is just a guess, but a build up of scar tissue over many years can cause a small increase in impedance. As Smitty said, it's not necessarily an indicator that the lead is bad or that it needs replaced, just that things are changing and I think that's a fairly small change. As I said, I kept going for 5 years after the first indication that my lead was bad. I forget the numbers but it was not a small jump, I want to say it doubled, then doubled again right before I had it replaced.

Extracting... they can't just pull them out when they've been in so long but they can still get them out. They use a laser sheath to work the lead out of the scar tissue.

Recovery from getting a new lead was fast. I had to watch the arm and all like the first time, but that's it. Other than that, it's no worse than getting a new battery.

Hi!

by Gellia3 - 2011-01-04 07:01:36

My dual chamber leads are 29 years old now.

Ventricular lead impedance last year was 438 and my atrial lead was 565. According to all my doctors my leads are still in great shape and doing their job just fine.

Smitty does make a good point that there are other factors to consider besides impedance, but if there is nothing else, just because your wires are 22 years old, doesn't meant they need replacing.

I'm going for a record if I haven't already gotten one! LOL
As my EP said, "If it ain't broke, don't fix it!"

Only you and your doctor can ultimately decide if it's necessary.

I hope you will let us know what you decide. I am esp. interested, with my older wires, in any information you get. Thanks.

My very best to you,
Gellia







Thanks for the info guys!

by montrealgirl - 2011-01-04 07:01:43

Hi there - I definitely will let you know what I find out tomorrow. I am in my final semester to becoming a Holistic Nutrition Practitioner - so the timing for an op is not so good for the next 6 months...lol However, it is what it is, right?

I put some questions into my pda - as I always get sidetracked during my exam.

I am trying to balance short term and long term planning here - because I do believe that when you are younger you have to consider how much real estate there is for the long haul.

Have a good night - wish me luck.

X

Follow up...

by montrealgirl - 2011-01-11 04:01:37

Hi Everyone,

Sorry for the delay....

My check up went great. My doctor jigged a few settings and is 90% confident I can make finishing school and writing my board exams in August and head in for a new pacer and lead in September.

We never went further than this - as everything is rock solid and too far away from surgery to do a vein test, etc.

So for me good news!

Wishing you all well.

You know you're wired when...

You read consumer reports before upgrading to a new model.

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I'm 43 and have had my pacemaker four weeks today. I'm looking forward to living another 50 years and this marvelous device inside me will help me do that.