Automatic safety switch from bipolar to unipolar

Oh gosh!

by Lavender - 2024-04-16 11:33:56

I can't answer your question but I have to say that I am quite impressed with the age of your leads!  🤩

I think this is a trapdoor function

by crustyg - 2024-04-16 11:37:22

It's a smart piece of design - your lead is no longer working adequately in bipolar mode, so to stay as a useful lead it's been set to unipolar by the device.

I doubt that your EP-team would set it back to bi-polar with that impedance.

I think you're correct.  Time for a new lead +/- some expert lead removal.  Centres that do a lot make it pretty much safe and routine, although we all know that it has a very, very small chance of going badly wrong, which is why the true experts have a lot of skill on immediate standby.

Best wishes.

Interesting dilemma

by Good Dog - 2024-04-17 13:48:30

You obviously have a couple of options available. I would think that at your young age that extraction may be the best option. I have to think that your vein is occluded, but if not they may be able to fit another lead in the vein. You will need a veinogram to determine that. If you do need an extraction, those old leads will be difficult to extract, so you need to be sure to trust that procedure to someone with a lot of experience. They could move to the right-side, but a couple of my Doc's at the Cleveland Clinic advised against it for a couple of reasons.

I find it interesting that my leads are about the same age as yours. My first two leads were implanted in January 1987 in New Jersey. One is still in-use (atrial #4016) and the other RV lead (#5024M-58) replaced a recalled lead that was capped in 1995. I would not be surprised if we have the same leads including the one that was recalled. I also found it interesting that they replaced your Medtronic device with a St Jude device? I am already on my 4th Medtronic generator implanted just last month. I would be interested in knowing more about your condition such as your EF and lead placement since our length of time being paced is so similar. I see that you are in Pennsylvania while I am in Ohio; perhaps not too far away. Although, I've lived in Lancaster and Chambersburg as well as central NJ near Philly. I'd also be curious to know where you are in Pennsylvania. If O.K. with you I'd like to PM you?

Sincerely,

Dave

interesting

by dwelch - 2024-04-17 16:34:38

I had two leads put in in 85 and the doc broke one in 97 and so then there were three. (one capped in 97).  Now there is four and that was a concern.  So we have some similar aged leads, would be halarious if they were the same brand.

I dont think five will fit without taking one or two out.  Or moving to the other side.

I was wondering if anyone knew if the device auto returned to bipolar and this was a temporary event and it had not repeated.  But I suspected it could only be tested/reversed in the office.

I have had what three medtronics, then st jude and now a boston scientific.  Current doc/office mix it up, if all patients are medtronic and there is a medtronic problem then all patients have a problem if only a third then ony a third.  Makes sense.  Was told the st jude would have a longer battery life 14 instead of 10 or so, but didnt get to find that out because of my EF dropping into the 30s it was time for a bipolar.  Which...is now unipolar...But appears to be working.  (yes the biventrical not only stopped the EF from dropping further but it climed back up, I think better than it has ever been.  Implying IMO it was from right side pacing for decades.   Always had a low EF, just going from 40s to 30s got their attention)

I didnt find out about the st jude until the rep, in the O.R. introduced herself, Im from st jude with your device, etc.  And only because the ekg machines were acting up that I was not in twilight.  I was fine with it, just wish they had told me before the last minute, or explained it after the fact.  Apparently I had a discussion (not sure about what) after the surgery, but I remember zero, was still out of it I guess.  Wife said he came in we had a talk.

Not sure which the boston sci or the sj jude, I guess I had too perfect of an atrial lead (the 1997 lead) that there was feedback that the pulse generated by the device as actually confusing the device.  Doc told me she literally spent the entire weekend going through every beat of my halter recording to find it (Decades with pacers and never one complaint until then, so she wanted to figure it out so she said).  They called in a rep/tech and all stood around as he showed them what he was seeing and what setting to change.

I have a mixture of brands of leads too.

PM is fine.