Wires but no pacemaker? Huh?

A friend had open heart surgery yesterday. One valve repaired, one valve replaced and one artery by-pass. He seems to be doing very well, but in addition to the obvious surgery site, he now has wires sticking out of his chest.

The nurse was asked what the wires were for and he said they were pacemaker wires in case a pacemaker was needed.

???

Doesn't anyone know about this? Do they often place the wires and wait on the pacemaker?

And what about the wires sticking out of the chest. Isn't there a danger of infection?

Or is there some kind of miscommunication going on?

8 Comments

Wires But No Pacemaker

by Lumpy - 2018-02-15 15:26:39

That is normal from my experience. I had lead wires after having a valve replaced. They are there in case heart rythm issues happen while in the hospital. The wires will be pulled out before they go home. Having them pulled out is another experience I may not want to do again!

External pacemakers after surgery

by LondonAndy - 2018-02-15 18:33:51

When I had my aortic valve replaced, in 2014, they attached an external pacemaker at the same time as doing the valve.  They had not said anything about this in advance, and I did not have a pacemaker before the surgery, but afterwards they said that because of the electrical functionality of the heart being close to the aortic valve, there is a risk of damaging the electrics.  They said that about one in ten ended up with a pacemaker.  The external pacemaker was a box with two knobs on it, which they could adjust to see if my electrical functionality had recovered after surgery.  One day the surgeons adjusted the knob during their daily visit to the ward, and I don't remember anything like feeling faint, just woke to find two surgeons pushing me back into the chair because I had passed out! 

A few days later a permanent pacemaker was inserted.  I don't know if they do this for all patients having an aortic valve replaced, or if it was because I already showed signs of electrical problems when they were operating.

 

Wires

by The real Patch - 2018-02-15 19:12:39

They're defibrillator wires in case they have to resuscitate you, and when they pull those suckers out your heart slams into your ribs. Hurts like hell

Thanks all

by Gotrhythm - 2018-02-16 11:37:58

Makes sense.

confusion

by The real Patch - 2018-02-16 16:29:07

One thing I've discovered causes confusion for patients, and even many nurses is that doctors tend to refer to pacemakers whenever they speak about ICDs, CRT-D, and of course pacemakers. I asked my Cardiologist why he calls everything a pacemaker and he said it's because he has so many patients he can't remember the specifics on every one so he uses that as a generic term.

No I've never heard of those wires being used in case someone needs to be paced, but I do know for sure after open heart especially they will attach two wires to the outside of the heart and thread then through the chest incision just in case they need to resuscitate someone as the heart has undergone high stress and tends to be quite irritated. Sometimes the heart tries to exact revenge for the abuse and they have to provide a jesus jolt. It's a pleasant experience let me tell you. Anyway the norm for the leads to be in is 3 - 5 days. In my case they were in 2 weeks and started to scar over vis a vis the pain when they hoiked them out. Pretty sure that's where "don't it make your brown eyes blue" came from.

Post Open Heart Temporary Pacer

by stevemerrill - 2018-02-18 06:55:12

I am a critical care nurse who has worked with post heart surgery patients.  As mentioned by some previous comments, temporary pacing wires are common following open heart surgery.  Remember that tissue that has been cut has an inflammatory response while it is healing (think of any cut you have had on your arm   - red, swelling, warm, painful, and decreased function - not as severe as with an infection, but deceased function nonetheless).  So, during the immediate post-operative period, the decreased function of the conduction system may result in temporary arrythmias that can be corrected by a temporary pacemaker.  Usually these resolve and the wires are pulled (ouch! - but better than wires coming through your skin forever - a pathway for infection).

On a lighter note, I have a CRT-D pacer and I was thinking the other day how humerous it would be to be able to be a "living defibrillator" at work -  someone codes and "Let's call Steve" - put some conductive gel on my hands, lay them on the chest, and THUMP!  But it would likely wear out my battery too soon :(  

Best wishes :)

Follow up post heart surgery pacing wires

by stevemerrill - 2018-02-18 10:31:18

Hi All,

Just a quick note of clarification regarding my previous post.  The conduction system itself doesn't need to be cut to be influenced by the inflammation and decreased function - that spreads a bit beyond the specific area of the incision, so as the inflamation resolves, the tissues regain function.  Some of this depends on the type of surgery.  Valve replacement is close to the conduction system and we used to see a lot of a-fib post op.  I don't work in that area any more, but I have read about the use of temporary bi-atrial pacing prophylactically to prevent the a-fib.  Another use for the wires and box.

Steve & "Sparky"

Thanks all

by Gotrhythm - 2018-02-18 15:52:50

I've passed your comments--all identifiers removed--on to my friend and his family. Your sharing of your experience dispelled some of their confusion and anxiety, and they have asked me to relay their thanks.

I thank you too. I just thought you'd like to know that your help extends even to people who are not members of the Pacemaker Club.

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