WISH ME LUCK! (update from a previous post)

On March 1st, I’m having a ventricle lead revision and pacer replacement. The decision has been made that I would receive the same pacer – Medtronic Adapta. My lead will be removed due to an issue and replaced from the RV apical area to the LBB area due to HF, (EF 40%), ventricle desynchrony, wide QRS @ 202ms. The DRs are optimistic that my cardiomyopathy will be reversed. I’m most nervous about the lead revision. The NP told me that the EP has done hundreds, if not thousands of revisions. I’m also nervous about being pacer dependent and how they will deal with that during the swap. Hopefully they knock me out! 

Also, during the work-up for this, they found that I have a thickened prosthetic valve leaflet which is causing a leak. It was previously thought to be a paravalvular leak. I'm seeing the cardiologist on March 22 to discuss. 


5 Comments

Replacing an RV lead

by Julros - 2023-02-25 15:05:07

I understand your concern about your lead revision, but it sounds like you are in experienced hands, which is key. I hope you will keep us updated about your LBBB pacing. It seems that perhaps this is trending over placing an LV lead, which I have.

I had a lead removal and replacement last September. I needed an ICD coil placed in my RV and was given the choice to cap and leave the old lead, or remove it. If I had chosen to leave the old lead, I could never have another MRI. At my relatively young age (65) I chose to have the old lead removed. I was nervous because I had known subclavian stenosis, that is, scarring around my leads which added to some of the complexity. My EP listened to my concerns, and worked with another very skilled EP to remove the lead, using a cutting catheter. They were prepared to use a laser if needed, and a cardiovascular surgeon standing by in case of damage to my subclavian vein. They placed temporary pacing wires because my underlying heartrate is about 30. The procedure went smoothly, and I was discharged home on the same day. The worst part was the long bed rest because they accessed both femoral arteries. The most painful part was the urinary catheter, lol. 

I wish you the best of outcomes and hope your EF will be corrected. 

Julros

by USMC-Pacer - 2023-02-25 15:22:06

"They placed temporary pacing wires because my underlying heartrate is about 30."

That's the scary part for me. I don't know if I have an underlying  heartrate, or rescue beat. I'm sure I probably do, but I don't like the feeling when they drop your pacing during testing.. You know, like you're going to fall out of the chair! I'm sure they have a way around it.. I hope I'm sleeping :)

I am confident you will be fine

by Gemita - 2023-02-25 15:53:09

USMC-Pacer, I would focus on your comments, “the doctors are optimistic that my cardiomyopathy will be reversed”.  That statement alone would give me hope and would encourage me to move forward with confidence, particularly as your EP has done hundreds, if not thousands of revisions.  

Have you had a chat with your EP about the procedure itself, how long it is likely to last, whether you would have a temporary pacemaker and about the type of anesthesia that you can have?   I would tell them exactly what you would prefer well before the day of your procedure.  If you want to be “sleeping”, then please tell them that and they can make sure that you have sufficient sedation so that you will not remember a thing.  

Please try not to worry about your underlying heartrate.  They will monitor you throughout the procedure and make sure that you remain safe while you sleep peacefully!  

From your comments, I am confident that all will be well and that your ejection fraction will improve with a well placed LBB area lead.  Certainly your EP was confident enough to say you didn't need a CRT device.  That is reassuring news.  Hopefully the transvalvular leak will only need watching.  

I send you my best wishes for a successful and comfortable procedure.  It will be over before you know it and you can start to live your life again

Thanks everyone for your reassuring comments.. This is a great resource!

by USMC-Pacer - 2023-02-25 17:29:20

I will update you all with the results! Thanks again!

God go with you

by Lavender - 2023-02-25 18:59:41

May God guide the surgeon as you go through this process. May He shine a light on the path, and hold you in His tender care. May you be restored and renewed. ☮️

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