Broken Insulation

I have dual lead Medtronic pacemaker since 1995. The battery has been replaced approx 7 years ago and I am due for battery replacement again.Currently I am operating in the conservation mode with only one lead sparking.

I have a faulty lead that needs replacing.

The pacemaker is implanted in left chest. When I try to sleep on left side the pulsing or sparking is unacceptable. I am limited to 180 degrees with nothing to the left side.I assume the faulty lead is sparking at the break into adjacent tissue when compressed.

The cardiologist will not remove faulty lead.

Here is my question :

Will the faulty lead conduct electricity from the heart back to the insulation break and continue the extraneous shock.

6 Comments

Broken Lead

by musser75 - 2010-05-26 02:05:07

Hi dwat,
trust in your cardiologist. If there is no infection, it's the best way to let the broken lead in place. As you have mentioned, Your lead is 15 years old and is 99% adherent to the subclavian vein ( the vessel in which the leads reside). To remove them, a special equipment is needed, procedural time will be prolonged and risks double.
Your cardiologist will close its end under the skin with a plastic inert cap, so it will be electrically isolated.
Everthings gonna be allright
musser75, MD

just did that

by Tracey_E - 2010-05-26 08:05:28

I was in the same situation and got a new lead in January. They left the old one, disconnected and capped it, then placed the new one on top of the old ones. Nothing to it! Once they disconnect the old one, it won't pulse or spark. Good luck!

Hi

by Gellia3 - 2010-05-26 08:05:42

I agree with musser. I had a loss of capture on my ventricle lead and it was disconnected, capped, sutured into place, and then I got a new one.
This lead did slip though, and is now looped in my ventricle. Very rarely does this happen and it doesn't bother me at all. That wire was from 1975.

My latest ventricle wire (1982) broke about 10 years ago and I was lucky that a new connector fixed it but at no time do I have a problem with the old abandoned lead (except for that loop - we do have to watch it for migration).

Sounds like your cardio (and musser) are right on!

Try not to worry about it. It's a very common procedure and not unlike when you first got your leads.

Good luck and please, let us know how you do.
My very best to you.

Gellia

Broken Lead

by SMITTY - 2010-05-26 11:05:48


In Oct. '09 my Medtronic pacemaker (KDR 700 series, implanted in 2000) went into VVI mode (conservation mode) without warning and what followed was quite a surprise. But before going into that further let me offer my guess to your question "Will the faulty lead conduct electricity from the heart back to the insulation break and continue the extraneous shock." I will say no because a PM lead is a 2-way street. The pacemaker uses it to sense the heart function and if it gets the information that indicates the heart's natural pacemaker is not working as it should it will then send an impulse. So if a lead is disconnected or broken, the sensing function would not be working and the PM would not send an impulse and would not cause an extraneous shock. Mind you, as I said that is my guess, because try as I may I could not get a clear cut yes or no from my research of the subject.

Now back to the VVI mode of my pacemaker. Prior to going into that mode my PM had been pacing my atrial at 90%+ of the time and the ventricle about 3% of the time. In VVI mode it quits pacing the atrial any whatsoever and goes to pacing the ventricle at 65 BPM 100% of the time. This was absolute misery for me. First, I didn't know what was going on. All I knew was I had a heart rate of 65 BPM and felt bad. But I could get my call returned from the Pacemaker Clinic. It was the next day. The main reason for my feeling so poorly was in VVI mode the PM pays no attention to what the heart's natural pacemaker may be trying to do and this can result in conflicting impulses from the PM and the heart's natural PM.

So even if you didn't have a bad lead, only one lead would be working in VVI mode and you will definitely have an unusual heartbeat.

As for your other question regarding the removal of a bad lead, I'll leave answers for that to the people that have had that experience.

Good luck.

No electrical problem

by ElectricFrank - 2010-05-27 01:05:47

To have any effect the lead would have to be attached to pacer. The amount of voltage picked up by the old lead from the heart wall is very small. The voltage from the new lead attenuates very rapidly in the heart wall.

frank

Thanks

by dwat43 - 2010-06-01 02:06:30

Many thanks for each comment on my question.I feel more knowledgeable and comfortable with pending generator and faulty lead replacement.

I have found obtaining information on pacemakers very difficult. Information from the cardiologist is limited and the Medtronic techs seem reluctant to enter the cardiologist's area of responsibility.

I wish I had access to this shared knowledge 15 years ago.

Thanks again for the comments and especially to those responsible for this forum.

Davew

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