Lead size & moving from Dual Chamber to CR-T

Hi All,

I got my first device when I was 7. Getting a new CR-T soon. My old leads (13+ years) still work but have caused SVC syndrome, blocking the veins. 

Now I’m going to need stents, laser lead removal and then my new device. I’m in Chicago and my doc specializes in laser lead removal so I am in good hands, I hope. The last we spoke he said there’s no easy way forward due to potentially negative risk and they’ll need 3 teams to clear out the leads, unblock the veins, put in the stents, then new leads and new device. I’m in my early 30’s.

Questions I have are how thin are the leads they now use? I can’t find info on them anywhere.

Has anyone moved from a dual-chamber to CR-T? I’m not concerned about size, just interested since I’m getting one. My left ventricle is not sending out blood in time with my right and my Ejection Fracture was 33%, I’m on drowsy drugs now which moved me to 45% until the CR-T is implanted and can beat the right ventricle.

Any realistic feedback would be welcome.

Thanks,

WF

 


6 Comments

Yikes!

by AgentX86 - 2018-08-04 21:35:00

That sounds like some tricky surgery.  I don't have any information on the size of the leads but I doubt size is the problem.  They, long ago, welded themselves to the sides of the veins and it sounds like plaque has built up aroung them.  the following is just a guess from what you've said but the new leads are likely the same size but your veins have to be opened up to get the third lead into the vein.  It ay be that they need to be opened up, in any case.

As far as the CRT pacemaker, I also have one (CRT-P) but more to prevent the low EF (mine is >60%, which is normal).  Yours isn't too bad and the CRT will likely help and it'll be great to get off the meds.  Trust me.

Are they implanting a CRT-D (with defbrillator) or a CRT-P (pacemaker only)?  Often, for HF they'll use a CRT-D but your EF isn't terrible, so it's just a datapoint.

size

by Tracey_E - 2018-08-05 10:29:20

CRT are larger than 2 lead boxes. Leads are considerably smaller now tho I don't know dimensions to tell you how much smaller they are. Good luck to you. 

Thanks for the feedback

by Winterfell - 2018-08-06 08:33:32

Thanks for the responses! My doc said the leads are tiny compared to what I have in.

They’re putting in a CRT-P.

The meds are terrible. Been on them for 6-months now and it’s irritating being so tired all the time. Seeing the doc tomorrow with next steps and then booking my surgery.

I’ve been looking into mortality rates too for all I need done but that’s hard to find. 

Thanks again,

 

Met with the Doc

by Winterfell - 2018-08-09 09:10:34

Hi All,

So I met with the Doc on Tuesday, he laid out my options and we chose the best one considering I am in my early 30’s.

They’re going to remove my device, remove the leads via laser lead removal,add a stent and then add a new CRT-P device with 3 leads on the outside of my heart and veins so I don’t end up with SVC occlusion again in 15 years.

We should be able to schedule it within the coming weeks as three teams will be needed for the all day op, they have to cut open my sternum. I had it done when I was 7 too.

Getting a CT scan next week so they can plan the op. And then should be in good shape to book it for Sept/Oct.

I feel great about it. Soon I’ll not be on medication:) and be better than before.

 

best,

WF

Good luck!!!!

by Tracey_E - 2018-08-09 18:46:04

Please let us know how it goes. Sounds like you are in great hands. 

Messing me around

by Winterfell - 2018-10-02 21:47:24

Hi All,

Update: my doc was all a go but the other surgeons were not. They said even though my SVC is blocked, I’m not extremely symptomatic and the rest of my body seems fine.

In three weeks the radiologist wants to add a third lead in a 6-hour op and 48-hours later my doc will replace my dual chamber with a CRT. 

Lest to say I’m not the happiest camper. Tomorrow afternoon I am driving 6-hours to Cleveland Clinic for testing on Thursday and I have a large envelope full of records and three cd’s full of images.

Got some pain on the top close to the center of my chest tonight like someone is knocking it with a small hammer from the inside.

if Cleveland won’t do anything more I’ll do it at my doc but if Cleveland will do the SVC unblock, I’ll cancel my ops in 3 weeks and get it all done with Cleveland. Apparently they’re the best in the country with cardiology and I need a second opinion.

WF

 

 

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