Recent CRT-D implant and worried about visible lead

I am 5 weeks out from a CRT-D implant, and for the most part I am doing ok.  The incision area still hurts, especially with my bra strap rubbing against it, but hopefully that will go away with time.

My biggest concern is the lead that I can clearly see and feel right under the bottom of my incision. It sticks right out like a swollen vein. Its very close to my armpit, so every time I move my left arm it seems like the lead will just pop right thru my skin.  I'm worried I will damage the lead or dislodge it somehow, or it will break thru my skin.  It also kind of sticks into my left upper arm when I try to move it to the right.   Has anyone else experienced this and was it ok to leave it as is?  I really don't want to have the incision opened again to move it.  I go back for my 6 week checkup next week, but I’m not sure if I will see my EP or just the device nurses.   

3 Comments

Leads under the skin

by Selwyn - 2019-05-29 20:03:25

I can certainly feel and follow my leads under the skin, from the incision site to under the collar bone. Moving my left arm to the extreme right worsens this scenario as the pacemaker bulges forward on the chest muscle. Sometimes moving my arm in an extreme downward direction will tip my PM into my collar bone.  The benefits of being thin!

When to be worried?

If there is pain or redness at the area of contact. Skin erosion is very rare. The pacemaker site should be inspected at each visit for a check up at the pacemaker clinic. It is important not to fiddle with the PM and leads ( so called Twiddler's Syndrome) as this can cause skin and implant site problems.

The lead is unlikely to be dislodged and the longer it stays in place the less likely this will happen. Leads do fracture with repeated movement- I, at present, have a lead with increased resistance, needing increased voltage ( and decreased battery life) to obtain an effect ( threshold). I suspect I may have a lead that is beginning to fracture- perhaps I have swam too many lengths? I did ask at the time of insertion  for a bit of slack in the leads to enable me to fully extend my arm for swimming front crawl. 

If you are having continued discomfort if may be possible to reposition whatever is the problem, but this needs to be done by an incision- yuk!

 

 

Visible leads

by AgentX86 - 2019-05-29 22:47:07

Yeah, mine can clearly be seen under the skin.  I may have 1/8" of skin over the PM and leads.  There is a hollow between the leads, which just accents them more.  It gets rubbed a little raw (not sure from the inside or outside) at times but it hasn't been too annoying.  I asked my cardiologist about it (he didn't implant it) and he said it was perfectly normal.

Sounds familiar....

by Elisabet - 2019-08-23 09:04:03

(Barb, just FYI I replied to a message you sent me a few weeks ago.)

I ended up getting a pocket revision. The doctor placed it deeper and more importantly was able to move the leads so that they were behind the device. They had moved somehow so that there was a loop between the device and my skin and it was very uncomfortable. 

Placement was somewhat limited because it was critical that it not interfere with breast imaging since I'm high risk. . 

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So, my advice is to go about your daily routine and forget that you have a pacemaker implanted in your body.