additional leads vs extraction

The subject of adding an additional lead versus extraction of the current one before inserting the new one has come up from time to time. I know extraction is not to be taken lightly, especially if they have been in a patient for a long time  I know there must be enough room in the vein for an additional lead but does blood flow in the vein enter into the decision of adding versus extraction?  Just wondering as my original leads are going on 20 years old and chances of lead problems become greater as they age.

                                     Rodger


5 Comments

leads

by Tracey_E - 2019-03-03 22:24:06

When I was in that situation, they did a venogram- iv with dye in the cath lab- to see how much space was in the vein. I had room so they capped off the bad one and added a new one. I can't do that again so next time one goes bad will be extraction. I already know I'll be high risk and my ep (whose team does many extractions) has already said he'll be sending me across town to another ep who has more experience with high risk than he does. Oh goodie <insert sarcasm font>

I think some of the decision depends on the surgeon's preference.  In my case ep left it up to me, and I chose to put off extraction as long as possible. I'm 52 now, so the longer I can put off extraction, the better the chances that my next set of leads is my last and I'm only extracting once. Also, technology gets better every year and surgeons get more experienced so I'm hoping that by the time I need it my risks are lower. 

I have one lead from 2011, one original from 1994. In addition to keeping an eye on the interrogations, every year my ep does an xray and echo to watch for the first signs of problems with the leads. So far, so good. 

Leads additional vs extraction

by CYBORG - 2019-03-03 23:25:50

ive Had a pacemaker since I was 11 ,I’ve just turned fifty I have I second set of leads added when I was 17 because the generator location was relocated ( thinking extraction back then wasn’t so popular ) those leads I received fractured twice( the first time age 26) the surgeon repaired (the second time age27) has to have open heart extraction went well . I would say it also depends on your age if you are younger you just can’t keep adding wires, good luck and pace on my friend 

LEADS

by Sylvia1 - 2019-03-04 18:18:22

My husband had only had his first ICD (Boston Scientific) for 2 years when both leads had fractured so they decided to remove all 3 leads and device,and after a good few hours under general anaesthetic they replaced with St Jude and new leads.A very experienced consultant carried out the procedure at a London hospital and after a night in hospital he went home the following day and recovered quickly.Wish you all the best.

Lead Extraction

by Buzbuz9 - 2019-03-05 01:18:04

So I'm 19 but I've had a pacemaker since I was 7 months old, and two years ago I had to have a lead extraction surgery because I fractured one of my leads. Through a lot of factors that go into whether or not you should have them extracted or not but age is likely the biggest factor for many. since I'm so young I'm definitely going to need more than one other settle leads during my life, and it's easier to recuperate from surgery when you are younger, so my ep had me have the extraction surgery. 

I will tell you that it was the hardest surgery I've ever had to recover from and by far the most painful. I have had those leads for 8 years. I was not able to function in daily life for over a week after the surgery.

I would just talk to your EP more in depth about what they feel comfortable with and what they would recommend in the risks and benefits for both. My ep actually brought in a lead extraction specialist for my surgery, but I'm sure every situation is different. 

old lead

by jazzy1986 - 2019-11-21 16:16:22

my ICD lead is 17 years old. but now it's time to either extract it or cap it off and add another one. ICD leads are harder to extract because they grab onto your heart tissue more than pacemaker lead. I have got few months to decide. from what I learned tissue forming on the leads is not so bad, it's the calcification. 

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As for my pacemaker (almost 7 years old) I like to think of it in the terms of the old Timex commercial - takes a licking and keeps on ticking.