Lead extraction/replacement

Hi,

I am scheduled for a generator replacement this week. My EP indicated that they will check the leads and replace/extract as needed. Has anyone had a lead extracted or replaced? I am concerned about the risk with either of these procedures.

In my last two medtronic pacemaker checks (at cardiologist's office), the rep noted a lead failure. Hence, i am very concerned that the lead will need to be replaced.

Any comments/advice would be greatly appreciated!

Thank you!

Angel

3 Comments

Extraction

by ElectricFrank - 2010-12-05 11:12:05

If there is a chance that they will need to extract leads, be sure the surgeon doing it has plenty of experience. Someone here suggested as lease 100 extractions/year was a good number. It is serious surgery.

Hopefully, the fractured lead can just be replaced leaving the old one in place.

frank

ask more questions

by Tracey_E - 2010-12-09 11:12:25

I was in the same situation last year. I asked for a venogram before my surgery to see if there was room to fit another lead. I didn't want any major decisions being made while I was out of it! If there was not room and I needed an extraction, I wanted to be able to plan for it and choose my surgeon, as Frank mentioned you want someone experienced with a busy practice doing an extraction. The surgery is a lot safer than it was even a few years ago so it's not anything to lose sleep worrying over, but it's not something you want just anyone doing.

Just because the lead is failing doesn't necessarily mean it needs replaced now, that's another discussion to have with your dr now, not when you're already headed to surgery. My lead went bad 5 years before I had it replaced. We kept an eye on it, it was working but killed the battery quickly because it was fractured- picture running the air conditioner with the window open, the house cools but the power bill is high. They left it up to me, I chose to put off getting the new lead as long as possible. When it got worse last year I had it replaced. There was room in the vein so we left the old one in there and simply put the new one in, nothing to it.

Good luck!

How old are your leads?

by TSan1961 - 2010-12-15 07:12:43

Hi Angel,
It really depends on how old your leads are. The newer ones are made differently with a screw type head, which makes for easy extraction. I have a friend who had that type of leads but hers were ones that were recalled a fews years back, only a year after her implant. She said her extraction and re-implant was done out-patient in the cath lab.
The older leads, like mine (they're 15 years old) have a hook type of head which is firmly embedded in the heart muscle.. I'm told it will be a much more complicated surgery requiring an operating room, full surgical team and cardiothoracic surgeon on hand. Scar tissue is another factor, the longer they're in, the more scar tissue and fibrous material builds up around the leads. My ventricle lead gave the "failure" notice over two years before it was replaced in October this year when I received a new PM. At this point both of my old leads are still in and I have a new ventricle lead implanted with the old one capped off. My cardiologist said he could not implant a 4th lead in that vein. Now my atrial lead is failing so I need to have lead extraction before he can implant the new atrial lead.
Do check into your cardiologist's experience rating to see how many he/she has performed. I still need to do that myself, as well as set up an appointment to discuss everything with my doctor and schedule the surgery. Guess we're in the same boat. Let us know how everything goes for you. Best wishes :))
Teresa

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