pacemaker leads life

I had a dual lead metronic pacer put in March 1997.  In 2013 the ventrical lead was replaced.  Any idea how long I can expect the atrial lead to last.  I am 80 years old and appx 16 months out from a battery replacement.


3 Comments

Depends

by Gemita - 2023-12-17 04:00:51

Judy I have read on this site that leads can last anything from between average life of 15 years to up to 25 years and sometimes beyond.  It depends how lucky we are and on a variety of variables.  

Sometimes if we have room in the vein to place another lead, they may do this and cap off the old one, rather than extract it, although extraction is becoming more common and safer today in the hands of experienced surgeons.

The lead impedance will tell our technicians/doctors how well the leads are performing. If the impedance is too high or too low, this might indicate a problem, for example perhaps a lead fracture or insulation damage.  

They also keep an eye on the threshold which is the voltage that is needed to stimulate the heart effectively to make it beat.  If the threshold increases it's not always because of a faulty lead, but often because of scar tissue around the tip of the lead.   Also, when the threshold is high, the battery will run down sooner than expected, because the pacer needs to stimulate using much more energy. 

At the time of your battery replacement, I am sure they will make the best decision on whether or not you need a new atrial lead.  I hope otherwise you have no concerns and that you are doing well?   

lead life

by Tracey_E - 2023-12-17 18:59:10

Lead life averages 15 years but there are a few of us here with leads that are 20, 30, or even 40 years old! My history is very similar to yours. I got my device in 1994. In 2010 they added a new ventricular lead and capped off the old one. My original atrial lead just showed the first tiny signs of wear on my last check. I'm 57 now and have less than a year on this battery. It's working well but since it's showing wear, I'm most likely going to replace it next time around. It's ok now, but odds are it won't last through this next device so I'd rather deal with it at 58 than 68. 

In your case, I would say they will not want to extract those very old leads given your age. I may or may not extract, I have a year to make that decision. There are options!

1. leave well enough alone for as long as possible 

2. add a new lead and leave what's there alone, if you have space. They can do a venogram (iv with dye in the cath lab) to see if there is room to do this

3. run a new lead from the other side

4. 2 chamber leadless pacing is very new but it is now FDA approved and has been given to a few patients who have existing leads. This is very new which means largely untested, but very exciting nonetheless for those of us with leads that have been in there for decades. Previously leadless was one chamber, and those of us with traditional leads did not qualify. 

5. There are places that specialize in high risk extraction. They can evaluate the condition of our leads, condition of our veins, etc to see just how high risk it is. I will meet with one of these specialists before I make my final decision. I am hoping for leadless, and I may or may not extract I'd like to get it all out before I get any older, but if the risk is too high I won't mess with it. Unless my doc decides the leadless isn't for me, then I won't have a choice. 

36 years and counting

by dwelch - 2024-01-25 05:38:04

I have two 36 year old leads, one is capped using the other.  One 29 year old lead I am using and the third one I am using is a handful of years.  Leads are all fine but for the first time the doc is wanting to have a talk about leads when we talk about the next replacement (years away).

 

You know you're wired when...

Your old device becomes a paper weight for your desk.

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A properly implanted and adjusted pacemaker will not even be noticeable after you get over the surgery.