28 and pregnant with dead wire

So I'm 28 years old and currently 13 weeks pregnant. I went in for a routine check-up on my pacemaker yesterday and found out that one of my wires is fractures and not working anymore. The doctor says that I need to have it replaced but it's dangerous to do during pregnancy because of the radiation exposure. I already have two wires in the artery as my previous wire went dead 3 years ago. He now wants to wait until after I deliver, but I'm nervous what this will mean for my pregnancy. Will I have to be on bed rest towards the end or have restricted activities? Will I be able to have a normal labor and vaginal delivery? Anyone out there going through a similar experience?

4 Comments

welcome

by Tracey_E - 2010-07-08 08:07:16

I've had a bad lead and I've had two babies with a pm, but not at the same time! Why do you have the pm, and which lead went bad? Is it totally dead or just impaired? When my lead fractured, they were able to program around it and keep it working. The fix killed the battery very quickly, but it paced like it should until I had it replaced.

If the lead that went bad is not the one you primarily pace with, then you should pace more or less normally until they can replace it. Example- I have av block and pace 100% ventricle but less than 2% atrial, so if my atrial lead were to totally stop working it'd be an inconvenience but not an emergency. I'm guessing this is the case with you because 1) you didn't have enough symptoms to feel bad before they told you there was a problem and 2) they could do replacement now if they absolutely had to but it's preferable to wait. They would not wait if you or the baby were in danger.

As for restrictions, etc, your cardio will need to talk to your ob. I guess it would depend on how this affects your pacing but my gut feeling is if they're not rushing you to fix it, then your pregnancy should proceed more or less normally.

I had a normal pregnancy and vaginal delivery both times. I was put on a heart monitor during labor told that if labor got too drawn out and/or my heart was stressed that I would have an immediate c-section, but everything went smoothly. Other than the heart monitor (and the odd looks because they'd never seen a pacer in ob!), I wasn't treated any differently from anyone else in the maternity ward. I was even allowed to be in the less monitored birthing suites rather than the regular hospital.

I worried about how things would go when I was in your place also, but it all worked out fine! I'm on my 4th pm now, my 3rd lead, and my babies are 12 and 13. Wishing you a smooth and uneventful pregnancy and a healthy baby.

28 and pregnant cont.

by dhobson - 2010-07-08 09:07:24

Thank you for your response TraceyE. To answer some of your questions; I have NCS (neuro cardiogenic syncope) and SVT (supraventricular tachycardia). This is my 2nd pm since 2002. The problem is with my ventricle wire which I use about 17%. I have actually been complaining to my doctor for the past year about feeling shocks on a daily basis from my pacemaker and he kept brushing them off. Yesterday when discussing my symptoms with the nurse, she checked my chart and noticed that my threshold has been consistently rising and my impedance was dropping. Based on this information, combined with the shocks I was feeling when they tested the ventricle wire, it was determined that my lead was fractured and extremely close to being dead.

Even though this doctor did not seem to think it was urgent enough to require immediate replacement, I'm very nervous because this past March I passed out for the first time since I've had a pacemaker. I'm thinking it's related to the fact that my wire has not been working properly for a year.

This is my 2nd pregnancy. And I remember being light headed and dizzy during that pregnancy with a fully functioning pacemaker. Now, I don't know what to expect being pregnant and not being able to fully rely on my pacemaker.

Per the advice of my mother who also has a pacemaker and my husband, I'm seeking a 2nd opinion. Just off of the information I gave them over the phone, he was very concerned about the wire and wants to see me on Mon. This is the same cardiologist who did both of my pacemaker procedures and my new ventricle wire 3 years ago as well as my mom’s pacemaker, so he’s very familiar with our family’s history.


2nd opinion

by Tracey_E - 2010-07-08 10:07:08

I think seeing the other dr is a great idea! They should have listened to you when you said you had problems a year ago. Who does your checks? Wondering if it's a nurse trained just to look for the basics or an ep or mfr's rep who are fully versed on all the readings because someone should have caught that long ago, that first report that had a jump. I knew mine was impeded (but stable) more than 5 yrs before it got worse and I finally had it replaced. The leads have several layers of insulation. As soon as the first layer ruptures, the threshold goes up but it can still work.

How much do you pace atrial? I'm no expert on NCS but I thought that was more atrial than ventricle pacing but I could be wrong.

Can you fit another lead or are they talking about extracting and starting over?

Let me know how it goes on Monday!

28 and pregnant cont.

by dhobson - 2010-07-08 11:07:03

My checks were being done by a nurse, although I did see the doctor back in December because they attempted to do a cathether ablation for my SVT, which was unsucessful and I still have episodes for that.

I don't remember off hand how much I pace in the atrial. I know it is more. I want to say somewhere in the 20-30% range.

I had been told before that my ateries were quite small. I already have two wires so my doctor felt that they would need to extract the existing two and then put in the new one.

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