Pacemaker lead extraction

Hello all, my first post here on the pmc site.

I have been the lucky recipient of a dual chamber pacemaker since 2012 just after my second aorta valve replacement!  I am paced 40% on top and have a fully blocked AV node.   I was recently told after my pacer checks a few months back that battery life is starting to go down currently @ 2.89 and my upper lead the impedance number is changing and starting to go low if I understood that correctly, which they believe Is caused by an insulation breach, exciting news!!  So I met with an electrophysiologist and he is recommending lead extraction for the bad lead.  He says I am too young to abandon the lead and to use my right side for the new leads and pacer. Save that for when really needed.

So my question to the group is, I am looking for a second opinion at Cleveland Clinic and does anybody know of a few names of an electrophysiologist that you might have used or that have a great reputation for lead extraction at CC. Does CC have a #1 guy for this procedure? 

 

Thank you.

3 Comments

Cleveland

by Tracey_E - 2019-05-23 09:50:24

Anyone at Cleveland is going to be excellent, you can't go wrong. At only 7 years old, taking your leads out should be fairly easy. In general when choosing a surgeon for extraction you want someone who does at least 100 per year.

Extraction may still be the best choice, but did they discuss capping the bad one and adding the new one on the left? That's what I did. We did a venogram (iv in the cath lab with dye) to see how much space was in the vein. I had room for a third lead so no reason to move it to the right. Mine are older than yours and I'm going to be high risk when it's time to extract so we chose to put it off as long as possible hoping my next set of new leads is my last. I still have one working lead from 1994, new one was added 2010, third one is capped. When one of these goes, we will extract all 3. The first doctor I talked to wanted to move to the right, the next one I saw offered extraction but agreed with my reasons to try to cap it and keep it on the left side for now.

Cleveland Clinic doctors

by Cheryl B - 2019-05-23 21:27:54

I, too, had a faulty lead.  And I also did the venogram route, good vein, put another one in same place.  Dr. Cantillon, Dr. Saliba and Dr. Kanj are all good.  I had Dr. Saliba for 10 years.  Not a real good bedside manner, but he is one of the best.  I now use Dr. Cantillon.  Very personable.  It was just time for a change.  

Good luck!!

Cheryl B.

LeadExtraction

by Moses - 2019-06-08 10:01:31

Thanks both of you for the comments! I have not heard of venogram before but I am hoping that during my upcoming visit with Dr.Wilkoff at CC that will come up as a possible option to discuss.

The electrophysiologist I met with her locally didn’t mention capping anything and just talked about removing because of possible infection leaving the leads in.

This whole thing is frustrating and making these choices are tough!

Thanks again.

 

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