Leads dislodgement

I had a complete new PM and leads put in on January 6, 2021 and started feeling like I was being shocked before I was ever released from the hospital . The nurses told me that was normal , well I'm finding out 5 weeks later when I finally got to see the rep from the company that makes my type of PM and get my interrogation box, that probably 2 of my leads are dislodged and that is why I am feeling the shocking feeling so strongly. She turned down the voltage and the feeling has stopped. But I had to have a chest X-ray done to see exactly what is going on. Has anyone else had this experience ? I did everything I was told to do , not to lift my arm above my head, no heavy lifting using that arm, wear a sling at night but not during the day. I followed the rules to a T . I truly believe they dislodged before I ever was released that first day. I need input please. I'm so discouraged and aggravated 😞


5 Comments

? Leads Dislodgement

by Gemita - 2021-02-11 13:40:08

Sharibee,

I am so sorry to hear about your difficulties although relieved that your immediate discomfort has been eased, at least for the moment, with adjustment of the voltage.  Can I ask whether you have confirmation that two of the leads are dislodged and that this was confirmed by a chest X-ray?  Until we know for sure, it is difficult to know how to proceed.  I note the company representative felt it was a possibility but you need to get a proper assessment and confirmation as early as possible.  Have you spoken to your EP or whoever implanted your device and has he/she suggested a way forward?

Are you getting any unwanted symptoms from the lowered voltage?    I would want to know whether a reduction in voltage could affect the operation of your pacemaker or whether the voltage setting at present will continue to give reliable, long term pacing? 

I have read it can be quite normal initially to have a higher voltage setting until the leads settle in and the heart gets used to pacing and then to reduce the voltage gently to conserve battery.  Perhaps your voltage was set too high at the start?  There are so many questions unanswered which is why you should go back to your doctors for a proper diagnosis and explanation of what has occurred.

I agree very much with Pharnowa about seeking a second opinion if you are in any way concerned about the ability of your current EP to help you, but I think first you need to establish whether the leads are really dislodged?

 

Maybe I am missing something, but........

by Marybird - 2021-02-11 15:56:06

If two leads are truly dislodged wouldn't you be feeling the way you did before you got the pacemaker? I could see where being dislodged would result in misplaced "zaps", but turning down the voltage won't fix the problems resulting from no longer pacing as you need to be. 

I can't think that misplaced or inappropriate shocks would be a normal finding from the get-go, unless the leads were not placed appropriately to begin with, and I thought it was standard practice to have a chest x-ray done before discharge to make sure the leads are in place, and there are no other related problems in the chest, around the heart or lungs. 

I agree with Gemita and Pharnowa that if there is a question about your leads being displaced, you need to contact your EP/ cardiology team ASAP to verify this, and to have them replaced. 

My sister had one of her two leads dislodged about 10 days after the pacemaker placement. She wasn't aware of feeling any different, but her EP's office contacted her to come in, have it checked out and the lead replaced into its rightful spot. She has no idea how it happened, but I suspect it might have been from rough-housing with her then two year old twin grandsons, she loves to do that. My guess anyway, she told me she decided to throw all post pacer surgery precautions to the wind about a week after surgery. They replaced it and she has been good to go since then. 

I'd check with your doctor.

leads

by Tracey_E - 2021-02-11 16:33:04

If they were completely dislodged, no amount of programming would help. If they are simply not in a good place, sometimes they can make it work by programming. 

When leads come dislodged, it's more likely it was not in a good spot, or the heart wall didn't like the lead or just bad luck. The least likely reason is something we did. 

I would have a discussion with the surgeon. If the lead is not in a good position, it might be best to fix it now rather than program around it and let it alone. The longer they grow into place, the harder it is to relocate. After the first year, it's so grown into place that it takes a special laser to get it out. 

Given the fact they wrote you off when you said there were problems, and now they are reprogramming because the leads aren't in a good position, you might want to consider changing your care. That's two strikes in my book.

Bad leads

by Selwyn - 2021-02-15 11:26:19

Don't beat yourself up about what you have done. You are not to blame. There is no scientific evidence to support the idea that arm position will dislodge leads ( see other posts on this subject). Your problems are entirely medically induced. 

Time to have a 'heart to heart' chat with your service providers.

Leads!

by 1955Mick - 2022-04-05 05:20:19

I know how you feel! Don't beat yourself to death over it. It's not worth worrying about what caused it. When I had my pacemaker implanted in February of 17 about 10 days later I passed a blood clot at home. Didn't know it at that time, and wouldn't go to the hospital. The next day my wife took me to the emergency room, and that's when they found out that I had passed a blood clot. They started me on blood thinners and I went back home. The next day I had an appointment to see my cardiologist. I didn't have the strength to walk 50 feet. Once I got into the doctors office they found out that the lower lead went all the way through my heart, and it had actually caused the blood clot. About 6 days later they transported me to a larger hospital and replaced the lead. 

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