Pacemaker and lead extraction

After 11 years with no real issues my pacemaker's infected and it's all gotta come out July 16th, exactly 11 years and 1 day after it went in . Dr. has me pretty afraid, says it's way more dangerous coming out than going in. Possible to perforate my heart and bleed out on the table.
Anyone else had an extraction, and how did it go? Hospital time and recover time to normal activity?
Thanks

8 Comments

Infection

by ElectricFrank - 2010-07-02 01:07:40

In your case my concern would be the infection that is causing the removal. Any time they do surgery around an infected area there is the chance of spreading it. You might talk to the doc. I would expect they would try putting you on one of more powerful antibiotics for a period of time to control the infection before the surgery.

This is something to realize in reading posts here. Most (but not all) the people who have had leads removed had it done because of a defective lead rather than infection.

One other thought..is it the pacemaker area that is infected or the leads? Infection in the leads or heart is much more rare.

frank

Thanks

by chuck m - 2010-07-02 09:07:58

Thanks for the response. Makes me feel a little better to hear that most extractions have gone well. I haven't used this site in many years and couldn't find a "search" function to see if this has been discussed. Being done at the Cleveland Clinic, they have a pretty good reputation, not sure if my cardiologist even told me who'd be doing it tho, he said not himself, as it's a very specialized procedure.
Infection is at the pacemaker site, echo does not show any infection down the leads or in the heart itself, but that's what they fear and why it's all coming out. I was on an antibiotic for 2 weeks, but it did not help. Started another yesterday.

Search function

by chuck m - 2010-07-02 10:07:21

Just found it, this will keep me busy for a while. Thanks again for the responses.

Cleveland Clinic

by Tracey_E - 2010-07-02 10:07:22

It doesn't get any better than Cleveland! You are in excellent hands. Very glad to hear the infection hasn't spread past the pocket. Best wishes to you.

PM Removal

by donb - 2010-07-02 10:07:38

Hi Chuck, just want to comment, you've had the best comments by Frank & Tracey. I had the same questions as I needed PM & possible?? lead removal and joined up with this group. Great support, learned more from the membership than the 17 years prior with my PMs'.

In my case I was put on Cipro before PM removal as tests were not conclusive if mine was rejection from allergy or infection as it all started about 1 yr. after my 3rdPM replacement. I developed a lot of scar tissue around the PM pouch starting where the leads entered the Medtronic PM causing pain & itching. Alergy tests showed positive to soft plastics.

After about another six months erosion started near the lead entry site on the PM and removal was done with leads left in place but terminated with large caps.
After 2 months without PM I needed another installation in my right chest along with another new pair of leads, St. Jude.

, Shortly after my left site eroded the lead caps and it took 2 surgeries to completely restore the old site with plastic surgery. I was very fortunate not to encounter infection as they continued with the antibiotic Cipro. My Plastic surgeon followed my instructions to removing the terminal & caps along with the excess coiled leads which finally healed the old site.

I did a lot of research on lead removal but with the antibiotic my old site was clear of infection and I was without a PM for 2 months as I'm only 1st -2nd degree electrical block. Knowing now what I've learned from this site I could have saved a lot of worry as lead removal is now very succesfull with new methods. As you're in good hands with Cleveland clinic and this site, I'm sure you'll do great. Any questions?? use Private Message. donb

risk

by Tracey_E - 2010-07-02 12:07:11

It's possible to take an aspirin and die of an allergic reaction. Everything has risks. Yes, taking it out is riskier than putting it in was but it's not nearly as risky as it was even a few years ago. The laser sheaths that they use have come a long way and the number of experienced drs has increased.

If you do a search of past posts here, you will find quite a few members who had extractions and are just fine, no complications whatsoever. I can think of one who's heart was perforated and she had emergency open heart surgery to repair it. Her recovery was longer and harder, obviously, but she's ok now. I believe her leads were looped in the heart, which made her extraction riskier. Every single other person here who has had an extraction went smoothly and without complications, on average an overnight stay and fairly easy recovery. If you dig through the posts, you can see their stories for yourself.

One thing I would do is find out how many extractions per year your dr does. If it's under 100, ask to be referred to a busier practice. This is something you want done by someone experienced, not someone looking to get experienced.

Removal

by ccallahan - 2010-07-03 05:07:46

I have not had this yet and do know the concerns as they were explained to me when they put it in, if anything had gone wrong what they would have to do. I would definately have them put you on antiobotics. I get staph and have to be on the at least a week prior. I would also ask why they feel you might bleed out. Are you on thinners? They should be able to handle and be prepared for anything to happen.

I will say a prayer for! Speedy recovery and good health soon!

Rev Chuck

9 days to go

by chuck m - 2010-07-06 08:07:05

Thanks again for the responses. I've been on another antibiotic for about a week. They took blood and put it into a growing agent to identify the infection. Turned up negative, so I think that means the infection is localized to the pacemaker pocket, which in my mind is a very positive thing. Got instructions from the clinic today, they say I'll be in the hospital for a few days to make sure the infection is cleared before they put a new pacer in the other side.
Chuck

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