Lead Extraction? - Help Me Decide!

Hello Everyone,

I am 30 years old and got a dual chamber pacemaker 7 yrs ago due to failed tilt table test. Since then, I have used the pacemaker less than 1% of the time and have realized I suffer from very low blood pressure (something which the pacemaker doesn't help). The batteries have run out and my doctors agree that I no longer need the pacemaker. I am now left with the decision of what to do:(. One surgeon recommends I take out the pacemaker and leads but another surgeon recommends leaving everything intact with dead batteries.

I am very scared of the surgery to remove the leads; I really don't want to die! I can't get a straightforward answer as to how risky the surgery is. However, due to my young age, I am concerned leaving the leads in will cause problems with mammograms (the pm is in my breast tissue), MRI's and there is always a risk of infection. Part of me now believes I should get it done now while I am young and very healthy..

Can anyone give me any advice at all? Do people die from this surgery often? Is the recovery awful? Can the surgery complications lead to more problems?

Thank you all in advance for reading my post...this site really is a blessing.

Amber

5 Comments

2nd opinion.

by climber - 2011-06-30 01:06:38

Looks like you may need another 2nd opinion. That's what I'm upto in the UK. I'm 49 with av block, PM fitted only last October, I think due to a failed tilt table test. I'm thinking of getting it removed, as it doesn't seem to be in use. I'll be looking at your post with interest to see what people say. I wish you luck with those answers.

My $0.02...

by shockbox340 - 2011-06-30 08:06:36

Not an easy decision to make. Yes, there are risks involved with lead extraction, but major complications are rare. An important factor in that complication rate is the expertise and extraction experience of your doctor. Five years ago, extraction experts were very rare, now there are lots of doctors do them. Quantity does not always equal quality. Do some research on how long your doctor has been doing extractions, how many he averages per month, etc.

If I were you, I would find the best extraction guy in my area and have it taken out. That being said, either decision is perfectly understandable, as long as you aren't your doc's 'guinnea pig' extraction case!

Best of luck!

had it done July 2010

by chuck m - 2011-07-01 01:07:52

Per your private message. My complications were blood clots in my upper arm from the PIC line to infuse antibiotics. The extraction and reinsertion itself went fine. My surgeon was one of the top guys at the Cleveland Clinic so very experienced.
When I first researched extraction I kinda freaked myself out, I read there was a 5% fatality rate. But then I found out I was reading old research and that the new laser method was MUCH safer.
I was in the hospital a total of nine days and never took a pain pill and was back bicycling in 2 weeks and running in 3, so my recovery was very easy.
If it turns out you need a pacemaker again in the future, will they be able to use the old leads if they're left in?
I'm curious about the tilt table test, both you and climber mentioned that. I had one scheduled right before they decided to do my extraction and it never got rescheduled. I still get real dizzy whenever I bend over, came on real sudden about 3 years ago and my general practitioner minimizes my concerns.
Chuck

DYSAUTONIMIA

by jessimay - 2011-07-11 09:07:12

Failed TTT, dizziness low blood pressure are all signs of orthostatic intolerance or postural orthostatic tachycardia syndrome, I have it and was diagnosed two years ago and will be getting a pm in a few weeks for severe brady and mobitz2 heart block.

anyways it's your autonomic system not your heart there for that's probably why the pacemaker did no justice. your autonomic system is responsible for regulating your heart rate and blood pressure and when there is a dysautonima that doesn't happen the way it should.

Update

by afreed - 2011-08-30 01:08:33

would just like to update everyone and let them know I had the pacemaker and leads extracted by Dr. Wilkoff at the Cleveland Clinic last week. I could not be more happy with my decision. The Cleveland Clinic was absolutely fantastic...I can't say enough good things. Dr. Wilkoff was so professional and really treated me respect and kindness. I haven't had any complications. I wouldn't trust anyone but Dr. Wilkoff to perform this procedure. I had much more scar tissue than anticipated and the leads had to be removed via my femoral artery.

Thank you all so much for your help as well. I really agonized over this decision and everyone's input was extremely helpful. If anyone reads this in the future going through the same decision process, please message me. I conducted so much research and would be more than willing to help!

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