Lead being changed, what to expect?

Hello everyone! I was planning on writing a cheerfull "everythings OK" note after my 3rd annual PM chek, but it turnes out one of my leads is broken and needs to be changed. The doctors have decided to extract the old one since I´m only 33. Can someone tell me what to expect during this surgery and afterwards? Anything I should chek in advance? I´m in Europe and most probably I will be awake during the surgery, like during the implant. That´s how we do it here :/ Does anyone have experiemce with that here? I got the PM for Sick Sinus Syndrome but I can live without it. Just faint a couple of times.

Thanks everyone already!


Uh - no, I don't think...

by donr - 2018-12-14 08:27:48

...you'll be awake during this procedure.  Removing a lead is a complex procedure done under general anesthesia.

A device is entered into the vein and uses the current lead as a guide.  It uses a Laser to cut around the lead and release it from the wall of the vein. Afer 3 yrs, that lead is attached to the vein wall by scar tissue & it cannot just be pullrd out.  A standby Thoracic surgery team must be available during the procedure in case the vein wall is perforated accidentally.  The procedure has about a 1-2% rate of failure requiring intervention by the Thoracic surgery team. 



wong information...

by Madamski - 2018-12-14 18:25:55

Thanks! So I guess the doctor was simply wrong when he said the procedure was less invasive than when I first got the PM. He did say he´s not entirely sure how it´s done in his defense, he´s just the arythmia doctor. I guess that means longer recovery time after the surgery too?

 I will have an appointment with the surgeant next week. Still makes me feel safer hearing from people who are more involved in these topics or have experienced it themselves.

Surgeants are not always happy to share a lot of information...


by Bionic Beat - 2018-12-14 23:08:32

The surgeons may not like to 'share a lot of information' but YOU are entitled to have ALL of your questions answered in advance!


Please get your answers before signing any paperwork.


It might not be more invasive, I havent had that done but you are entitled to know.


Best Wishes,


Bionic Beat

Lead extraction

by Sibber - 2018-12-15 08:38:02

Lead extraction and re implant is a routine procedure. However it does carry slightly more risk than other procedures (though still low) and therefore is done by skilled and trained extractor, at least in Europe. There are a number of techniques used to remove leads such as sinple traction/pulling to dissection sheathe cutting tool and lazor. These depend on a number of factors such as the type of Lead, how long it has been in and operator preference. Extraction of leads that have been in a long time is done under GA, however leads that are newer may be done under using local and sedation only. You will be fine


by dwelch - 2018-12-19 12:06:51

I have a "spare" (broken) lead that was never removed. and am using my other three so cant help you on that front.    

Am on pacer number five.  Not all the same surgeon.  They vary, overall like your first implant but you have now been through it, so its not all new to you just the recovering from surgery part.  I was ready to go back to work after a couple three days, but since that put me at the weekend waited for monday.  Most of mine have been that quick.  Being able to sleep on that side or through the night well that is another story, wash my hair with both hands, etc.  Those things take weeks to be back to normal, tiny bits of progress each day.   But this is nothing new you have done this before.

My first docs rule was new lead you stay the night.  So first pacer stayed the night went home the next day.  Second, broken lead, new lead stay the night.  The next few were go home the same day.  Most recent went from a 2 lead to 3 lead (at your age this should happen eventually a decade or two down the road) was some confusion but I insisted on staying the night, didnt sleep anyway, got some antibiotics I wouldnt have gotten had I gone home.  

At your age you are going to be a pro at this, nothing to worry about...


Oh yeah, first two I was awake, the rest not...different surgeons different towns different periods of time in history...



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