Bi-Ventricular Pacer lead came loose

Hello,

Totally new to this site, was a great "find" though.  I had an Bi-Ventricular Pacemaker installed 4-25-11, it seems to be arcing off of my diaphragm, the lead has come loose, anyone else with this problem????

I’m scheduled for surgery Mon. May 9, 2011. This has really thrown me, I had never expected a lead to pull loose from the heart........anyone else had this problem?

6 Comments

That must have been a surprise

by ElectricFrank - 2011-05-07 01:05:43

I haven't had the problem, but it happens. Keep in mind that the surgeon implanting the leads has to hit the heart wall just right when it is wildly jumping around. There are two common types of electrodes. One uses a barb type end. If it wasn't embedded far enough it could come loose. The other is a screw type device. I'm only guessing, but I would think it would have less chance of failure because even a shallow insert would allow screwing it the rest of the way in.

Of course you could help by stopping your heart during the procedure. Maybe not a good idea though LOL

frank

Coronary sinus lead

by golden_snitch - 2011-05-07 02:05:50

Hi!

Have not had this problem, but have a friend with a CRT (bi-ventricular pacer) and know that this is more common in CRT patients. It's mostly because the third lead, the one for the left ventricle is actually not attached to the heart muscle but remains completely in a vein running across the outside of your left ventricle ("coronary sinus"). As far as I know, it is not uncommon that this lead can cause diaphragmatic pacing; my friend had the problem, too, but it was fixed by changing settings (lowering electric output of the lead).
Another way to implant this third, left-ventricular lead would be to place it epicardially --> sew it onto your left ventricle (no vein needed, but a mini-thoracotomy to attach it to the heart muscle from the outside). However, placing a lead epicardially is much more invasive than placing it in a vein.

There is a helpful article showing how that coronary sinus lead is placed at:
http://www.washingtonhra.com/22.html

Best wishes
Inga

Bi-ventricular lead loose.

by graham1 - 2011-05-07 07:05:01

Hi dustin050.
See comments entitled "Recovery" on 2011.05.04 by Steele17 in this Recent posting. I think you will find this is a commonish problem.
Graham2

Lead Loose

by drashmore - 2011-05-08 08:05:46

My lead came loose. I came out of the hospital and within 2 days has a really bad cold. I had a terrible cough. They said the coughing is what caused it to come loose. They went back in to the same incision and reattached it. The big thing was I started all over on my 2 weeks of "don't move your arm and no driving." That was a pain. That was back in Dec. The doctor says my incision looks really good considering it was reopened. No I'm just dealing with other issues dealing with my heart rate.

Good luck with your second surgery, one thing this time, you know what to expect.

Thanks Inga

by ElectricFrank - 2011-05-08 12:05:26

It looks like placing the second ventricular lead is even more complex than I had realized. I appreciate the link.

frank

3 lead revision

by Kaffer - 2011-06-01 10:06:32

I am having my third attempt of the epocardial procedure tomorrow. The first surgery they could not get a third viable vein due to my small venous system. The second surgery was successful, but my ICD check was showing no capture. My x ray confirmed that one of the Atrial leads and my left ventricle lead came out. If he is not able to get the leads this time they will be attached to the outside of the heart. Over the last week my energy has dropped and my other CHF symptoms are worse. I hope this next surgery works. I can't keep missing work.

You know you're wired when...

Your old device becomes a paper weight for your desk.

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