number of leads

I just had my third pacemaker after 16 yrs of the first two. When I was recovering from the surgery and still a little hazy, the surgeon casually mentioned to me that I now had only one lead instead of two. "You didn't need two", he said. This did not register until I returned home. Am I too concerned about this?
No explaining at all. My cardiologist was not even there. Only the surgeon and the factory rep. Isn't this unusual also? I am not seeing anyone for a week, so am wondering. Thanks

7 Comments

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by Tracey_E - 2011-10-29 10:10:31

Something is odd! They did not take one out. After 16 yrs they don't just come out on their own, it requires specialized procedure to remove it from the scar tissue that builds up after so much time.

So, the questions I would ask are first, did they switch you to a 1 lead device and if so WHY?? I've never heard of that, even if you don't use the second lead it provides information so it would be silly to downgrade you to a one lead when you already have two leads. The main reason for going with a single lead is avoiding the second lead or 2) is one lead no longer working? I'm guessing that's the case but it should still have been discussed with you.

I had a bad lead for years before I chose to change it out, had two battery changes knowing the one lead was bad. Then it got worse and I had it replaced when I got my last new device. So, if you have one lead no longer working and they simply programmed it to not use that lead since you don't use it, that sounds like a good decision rather than adding a new lead if it's not necessary BUT it's something you discuss with your dr, not something they decide for you and tell you later. Good luck getting answers

Other possibilities

by shockbox340 - 2011-10-29 11:10:07

Have been told that you are in atrial fibrillation or a-fib? Patients are sometimes "downgraded" from a dual chamber to a single chamber device at change-out when they have developed chronic a-fib since the last procedure. Yes, they can keep you on a dual chamber, but the extra information is 1. not needed if they don't think you will come out of a-fib (very unlikely if chronic), and 2. an extra battery drain processing that data which shortens your battery longevity.

Is it possible they damaged the lead? Sure. But my money is on the chronic a-fib reason. If that is the case, your doctor did you a favor by giving you a device that will last longer.

New Pacemaker

by SMITTY - 2011-10-30 01:10:33

Stan,

I have been especially interested in what yours and others comments about A-Fib as it is something I have been living with for several months now. So far all my Dr has offered is an anticoagulant to prevent strokes. I can see I'll have new questions for him during my next visit.

Now for some info on your new PM that you may not have. Your product number ADDRO1 is a Medtronic ADAPTA ADDR01, in case you do not have that.

Much more information on this PM is available at http://www.medtronic.com/for-healthcare-professionals/products-therapies/cardiac-rhythm/pacemakers/adapta-with-mvp-pacing-system/index.htm. Some of it delves into the important of MVP pacing by this PM.

The following is from www.Heartpouint.com and may tell you a little about what your Dr may have had in mind when he gave you a single PM lead. From what you have said, I think #2 is most applicable to your problem.

Single lead pacemakers are used primarily in four situations:

1. When the only problem is with the formation of the initial impulse in the atrium, simply placing a lead in the right atrium will "start things off" when it's needed, and the electrical impulse will then continue normally through the rest of the atrium, the AV node and the ventricles.

2. When the patient is in chronic atrial fibrillation and the ventricle is going too slow atrial fibrillation. In this case, only a single lead is placed in the ventricle because the fibrillating atrium cannot be paced.

3. When the problem with a slow rate occurs only occasionally and for relatively brief periods of time, a single lead in the ventricle may be all that is utilized to provide brief help at those times.

4. A special lead which can sense in both chambers, and pace only in the ventricle is also useful in some situations, and is discussed below.

Good luck,

Smitty

Battery drain

by ElectricFrank - 2011-10-30 03:10:20

Actually, the main drain on the pacer batteries is from the current used to actually stimulate the heart. The electronics including data recording takes almost nothing. I kept my old pacer when mine was changed out in Jan 2010 for depleted batteries. Being an electronic engineer my curiosity has gotten to me so I hook an oscilloscope to the ventricle lead connection to see what it is doing. It is still running just fine while it records that I have no heart beat and keeps trying to make one happen. LOL

I agree with Tracey. Something is odd. Either your being hazy you may have misunderstood, or a bit more explanation is in order.

frank

Re previous comments

by stan2ee - 2011-10-30 12:10:48

Yes I do have chronic AF, so perhaps that is the reason for down grade to one lead. My first pacemaker was inserted in 1996 and second in 2003.
I have to plead ignorance on this "battery" change, since I assumed the unit was self contained and when it was changed (last week) I had a completely new unit. Is this correct? I also assumed I was receiving a new digital type unit. The paperwork indicates an implant of product ADSR01.
I can see a need for more questioning when I return on Nov 4 for a check on the wound.

Thanks for the update Smitty

by ElectricFrank - 2011-10-31 02:10:44

Makes sense.

frank

battery

by Tracey_E - 2011-10-31 07:10:40

we say battery, but the whole unit is self contained so you actually get a new pulse generator and battery at the same time. Only the leads are left alone.

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