Leads hitting a nerve???

I was just at the local Pacer Clinic getting checked because of "issues" I have brought up in this forum previously (quick squeezing feeling, coughing, strange feeling in my neck, etc.) My Tech brought in a second Tech to check me out too. It appears that my Ventricle lead is likely stimulating a nerve!?!?! They could actually feel little spasms every time they made the lower lead (ventricle) work AND I could feel it in my chest and throat!!!
So now I have to go back to the hospital where I got the PM and they want a PM Doctor to check it out - which I'm obviously okay with - BUT
I can't be the only lucky one to have this kind of thing happen... can I???
Thankfully, I pace VERY little (0.3%) in the Ventricle, but it appears that the lead is irritating or stimulating nerves even when it's not firing (like when I move certain ways or lay in certain positions.) But what if I start to pace more?!?!?
My PM Tech sya they may want to go in and "move the lead".
Has anybody had this done???
Has anybody had a lead stimulating a nerve?
Does anybody want a good deal on a used PM?
Arrrgh!


6 Comments

Lead Revision

by saragunther - 2007-09-14 11:09:18

Yes, I had the very same thing happen to me.After only two weeks of my implant I felt as if there were a gremlin inside of my chest wanting to come out! I must say the sensation drove me crazy. It seems that one of my leads was too close to a stomach muscle which caused the creepy feeling and the only way they could fix it was to go in and move the lead that was stimulating the muscle.That's what they call a lead revision and I had one done and no more gremlin! If that's what they have to do with you you'll be fine and you will no longer feel those spasms. Good Luck to you, it's a piece of cake. Sara

Question

by Vicki - 2007-09-14 11:09:38

I read in a prior post you did about having a numb feeling in your diaphram. Wondering exactly what it felt like, hard for me to imagine. Reason I ask is that one month after PM, I have been feeling like I need to take deep breaths quite often. Not really short of breath just the urge to take deep breaths. Hard to explain.
Vicki

Leads Hitting a Nerve

by chicken1000 - 2007-09-14 11:09:41

Hi dward!
I am a nurse who also happens to have a pm so I know both sides of the picture- as a practitioner and a patient! It is possible for your leads to shock a nerve, especially the left phrenic nerve which runs along side the left ventricle and innervates the diaphagm. I noticed a lot of throat tightness and coughing after I had my pacemaker implanted and my pm nurse was able to check (during my pm interrrogation) whether my phrenic nerve was being stimulated. Luckily it was not and I was probably just becoming anxious while pacing during the first week. But, it could be that either your phrenic nerve or vagal nerve are being stimulated. Your pacemaker leads are going to be with you for a long time- i.e. the rest of your life! So I would want to have them located in the best place. If your cardiologist suggests moving them, then I would agree. Hope this helps and good luck!

--Jenn

Stimulated Nerve

by SMITTY - 2007-09-14 11:09:43

Hello D Ward,

Been there and done that. My difficulty was not exactly like yours, but as I have often heard said, it was close enough for government work.

A ventricle lead was stimulating a nerve on the right side of my chest and it felt like an electrical shock in that it was instantaneous and would last for a millisecond. The intensity of the pain was about like that of a bee sting. This started about three weeks after I got my pacemaker and I was told time after time it was not my pacemaker. Fortunately my pacemaker did not have anything to do very often (I’m guessing it assisted my heart about one or 2 percent of the time) so my shocks didn’t happen every day but they could last for several hours when they did start. This went on for a little more than two years and I asked to have the pacemaker turned off as by then I had decided that I really didn’t need the dang thing anyway.

It was restarted by another doctor about two years later to see if the pacemaker would help my shortness of breath. It didn’t, but the stent he implanted a few weeks later did the job.

My shocks continued and I went to another electrophysiologist. After a lot of tests it was determined that the lead to the ventricle that was causing my problem. I was given the option of having that lead relocated to a different position or I could try a steroid injection to deaden the affected nerve. Since the lead relocation involved possible replacement of a lead that had been place for five years I chose the injection, although I was told it may not work and if it did work it may only last from six to nine months. It will be two years in October and everything is going fine even though my pacemaker now works about 90% of the time.

No, my heart condition is not worse, but in April a young cardiologist insisted that I take a beta blocker and although the low setting on my PM is 60, the beta blocker drives my heart rate down to the mid-forties so the PM brings it back to 60. Other than giving my PM something to do (my heart rate will be in the upper sixties without the beta blocker) and making me feel as if I have the flu all time, I’m not sure what the beta blocker is doing for me. I'll get that answer on 9-20-07.

So you are not the only one, and I have seen others post messages here that have a similar problem. I wish you good luck with getting a solution. Hopefully is will be as simple as mine was.

Smitty

lead problems

by peter - 2007-09-15 03:09:47

When I was having my pacemaker fitted the left ventricle lead was pacing my stomach violently. Impossible to live with. Another longer lead was fitted but I still had occasional stomach pacing. Thank god this has completely stopped after 4 months and I can get to sleep without problems.

stimulating

by TOGUY - 2007-09-15 04:09:51

I have had my PM dual lead for almost 5 months now. I have been coughing since the implant. My GP has done everything to see where the cough is coming from no luck. I think one of the leads is stimulating the cough. I will bring this up with my card. later this month..I think many of us have some type of lead problem. Let us know what develops and I will keep you informed if I get any answers.

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