Worried

Hi, my name is Amanda and this is my first post. I am in search of some help in getting some answers. My 83/84 yr old grandfather has had a pm for several years. He is at the end of battery life of his second one and has been waiting for replacement. He did his regular call-in checkup, was told to come in and was told that the bottom half of his heart is pretty much dead and the top half is 95% reliant on his pm and that they want to add a 3rd lead and that it would be an extremely tricky procedure. We are looking at congestive heart failure at anytime w/o the procedure for certain. Or with the procedure, he can extend his time for unspecified amount of time, if he survives the surgery, but still end up with congestive heart failure.
My grandfather, albeit in his early 80's is an otherwise healthy man - even going hiking & hunting this summer in the Ruidoso Mts and nabbing himself a big black bear.
Has anyone gone through and known someone who has gone through a third wire placement such as this? They said they will have to go in the same artery that the 2 leads are already in. But when it gets to just above the heart, it has to veer off down a vein and wrap around the back of his heart.

7 Comments

Bivent Pacemaker

by SMITTY - 2011-12-27 11:12:15

Hello Amanda.

Welcome to the Pacemaker Club.

I'm 82 and close to your grandfather' age and I when read a post like yours I get more than just a little upset with doctors. OK, so your grandfather's upper chamber requires help from a pacemaker but the bottom chambers are not dead. They just need help to contract more fully which the two lead PM he currently cannot provide.

Now, I don't have a biventricular (3 lead) pacemaker, but I know what they are and what they treat as I was diagnosed with congestive heart failure several years ago. I have had several discussions with the Dr about my getting a bivent PM, but I'm not to the stage yet that one will be of much help.

Getting a bivent PM is a more delicate surgery than getting the two lead PM, but this is the first time I have heard it said it is an "extremely tricky procedure." That makes me want to ask just how much experience does this Dr have implanting pacemakers?

Also if your grandfather is as you say "an otherwise healthy man - even going hiking & hunting this summer in the Ruidoso Mts and nabbing himself a big black bear" my question for you and him is does shortness of breath cause him many problems? Based on what you have told us, and if he is not experiencing SOB I would suggest that he get a second opinion.

I wish your grandfather the best,

Smitty

Boston Scientific 3 lead

by jobal - 2011-12-28 11:12:31

Hi Amanda,
I had a Boston Scientific PM/Defibulator 3 lead installed last May. The procedure took and extra 1 1/2 hours longer than a regular PM procedure because they needed to sincronise(don't think thats spelled right) the pumping of the bottom chamber of the heart with the top chamber. It is still considered minor surgery. This gave me more air in my lungs thus giving me a better quality of life. I am only 53 and was diagnosed with Dilated Cardiomyopathy (CHF) in April 2011. I feel alot better now so I would recommend it. I hope this helps. Good luck.

jobal

Good Points

by mckate - 2011-12-28 11:12:34

Definitely agree on getting a second opinion.

What!!!!

by ElectricFrank - 2011-12-29 03:12:17

The bottom chambers are the main pumping parts of the heart. Someone is making up wild stories about the bottom chambers being dead. If they were the patient would also be dead.

I agree with Smitty that a second opinion is in order ASAP.

frank

Third lead

by CIED´s Tech - 2011-12-30 11:12:44

Hi Amanda,
First of all, the implantation of a third wire may have some complications, since the physician must pass the new electrode next to the existing ones, and must be careful not to damage them. The third electrode is placed indirectly in the left ventricle through an anatomical structure called the coronary sinus. The idea is to stimulate both ventricles at the same time; or one first and then encourage the other with several milliseconds apart. 3-wire devices are known as CRT-P's (Cardiac Resincronization Therapy- Pacing). The function of these is to resynchronize the ventricles and increased ejection fraction, this is the amount of blood per minute pumped by the heart.
There are clinical guidelines that indicate whether a patient is eligible or not for this type of therapy. It is also likely that despite having this therapy the patient does not improve their clinical condition, known as non-responders. This may be due to several factors such as cardiac anatomy, the position of the coronary sinus electrode or if the person has suffered cardiac tissue damage due to stroke.
I recommend you consult with a cardiologist-electrophysiologist, who are the true experts in these cases. I hope this information will be useful.

Thank you

by MrsH04 - 2012-01-02 08:01:04

Thank you all for your comments and information.
An update. Since my grandfather's PM's batteries are almost dead, he cannot have the 3 wire one put in until the batteries on his current one are completely kaput.

He is kind of in limbo atm. His batteries on his current pacemaker (the 2 wire) are just about dead - they have been pretty low for the last 3 months or so. They will not replace it until they are completely gone. Even though his drs say he needs this new 3 wire pacemaker, he has to wait for it.

So now he is in a call-in-and-test pattern to have it checked regularly. Hopefully when he does these call-ins, they will catch the soon-to-be-dead batteries, and they dont go out in his sleep or other innoportune moments.

My Dad

by navy_bill - 2012-01-17 01:01:17

My Dad had his first ICD implanted when he was 70 and ended up having his second when he was 83. He too had congestive heart failure on top of a quad bypass and at least 3 heart attacks. The doctor said, after the second implant, his heart was in real bad shape...good assessment. Be that as it may, the operation was quite successful and he lived well for a couple more years, albeit not as active as your grandfather...God bless him he seems a real trooper. My Dad would have lived easily into his 90s if it was not for another hospital visit to have is gall bladder removed. It was in the hospital that he contracted a virulent strain of MRSA which overwhelmed his ability to fight the infection. He succumbed to pneumonia. Take the recommendations from above. Go for a second opinion. Please let us know how this works for your grandfather.

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