Doctors different opinions

New EP just recommending battery and lead replacement. Says due to recalled wires, noise. Former ep said surgery too dangerous for my husband, due to scar tissue, 10-15% ej. He's 65, had two ablations, 7 heart attacks, quadruple bypass, 8 stents. I'm worried. Old ep retired. Maybe I'm just not sure of the new one yet, or maybe old ep was putting surgery off cause husband died on table 3 previous times? Advice please

4 Comments

tough one

by Tracey_E - 2018-07-07 12:06:44

How long ago did the former ep say it was risky? Lead extraction surgery has come a long way in the last 5 years and it much less risky than it used to be. Doctors vary. Some are quick to remove and start fresh,others are more hesitant to mess with old leads and work with what's there.

If the leads are recalled, it's best to replace them. If there is noise that usually means they have to crank up the juice to get them to pace which kills the battery more quickly so it sounds like new leads are a good choice.

Have they mentioned leaving the current leads in place and putting a new one in from the other side? Sometimes that's an option when there isnt' room for new leads on the current side but they don't want to extract. I'm assuming from his history he has more than a simple 2 lead, a CRT or defib? I have no idea of those can go on the right side but it's worth asking. 

If he ends up looking at extraction, you want an electrophysiologist that does a minimum of 100/ year, even if that means traveling to have it done. It's not as risky as it used to be, but it's still complicated so you want someone who does it often. 

 

Different doctors

by Worried wife - 2018-07-07 15:34:05

Thanks for your input! He does have a two lead icd. The top doesn't work, and the bottom is a recall. This is his second icd with the same leads.

Wow! That is a tough one.

by AgentX86 - 2018-07-07 21:20:57

He's so young (I'm also 65)!  Yikes!

I agree with Tracy. With his heart history it's a really tough call (one I'm certainly not competent to make).  You really need to find the best EP in the largest/best hospital possible.  Tracy's last paragraph is key. You need the best of the best.

decision

by The real Patch - 2018-07-07 22:45:02

This is a decision only your husband can make, don't ask a bunch of strangers for advice for heavens sake. There's no question there is risk anytime we have surgery and they dink around inside our hearts. No question that people die, but they have improved extraction of old leads and the risks are a bit overplayed today. You need look at the pro's and cons and decide which risk is most acceptable to you. What I think or did doesn't matter cause you ain't getting me no matter the outcome.

 

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