Endurance Heart causes collapsed lung

Hi everyone. I am new to this forum. On Wednesday I had a Medtronic Azure pacemaker implanted. I requested they place the pacemaker under my pectoral muscle so that it didn't interfere with swimming and also requested the pace me at 50 while resting and 170 for the high with an aggressive response rate (4 on the scale of 1 to 5) for running. My pre pacemaker healthy resting heart rate was 48 prior to dropping to the mid 30s. They also set my sleep heart rate to 40 between 10p and 5a.

I had the pacemaker implanted because my resting heart rate was continuing to drop, I was experiencing low heart rate AFIb (30s) and had slipped to AV block 2 with over 1000 delays for up to 4 seconds.on my runs I would have to walk for the first 10 minutes before I could slowly jog and many times I couldn't catch my breath. I am 68 and still competing in endurance events (running/biking/swimming) and have since I was 10. With over 135,000 miles of running, 100,000 miles biking and 10,000 miles swimming I have a few miles on this body and heart.

I was the last patient of the day and got home around 9p. My pacemaker thru my phone uploads to Mayo and Medtronic very midnight. The first reading went to them Wednesday night. The second reading went to them Thursday night. Friday morning I got a call from Mayo asking me to come into the clinic for a chest xray and device check asap.

Long story short, they found they were having trouble communicating to the atrial lead and I had a partially collapsed right lung. It is a low risk (1%) that the left lung could be punctured during implant but they have never heard of the right lung being punctured. They think what happened is the atrial lead was placed in the thin wall of the atrial dome (their words) and my athletic heart beats so hard that the screw tip on the lead pierced both the atrial wall and my lung. That's why they couldn't communicate with it and my lung collapsed.

i was immediately admitted to the hospital and put on oxygen with a rebreather mask for 4 days to stabilize my lungs, with chest X-rays ever morning, so they could reposition the atrial lead. Last Monday they successfully did that and I was sent home Tuesday with strict instructions to do nothing for 4 weeks. I go back in on the 29th for another chest xray and device check. I was able to avoid a chest tube to drain the excess air outside lungs which everyone has said is very uncomfortable.
 

An unusual and interesting journey to a simple procedure that I thought you might be interested in.

4 Comments

I'm impressed by your mileage - WOW!

by USMC-Pacer - 2024-04-19 13:49:42

I've never realized how many things can go wrong in "simple" procedures until browsing this site. Unfortunately it's what brings folks to this site looking for answers or others experiencing the same. I can't relate but I'm sure someone will be along shortly that can. Just wanted to say welcome aboard and sorry for what you are experiencing. At least they caught it early and I'm sure you will be up and running again shortly. :)

Amazing

by Lavender - 2024-04-19 22:43:47

What an astounding tale! You sound so calm about it all. 😉

I am glad you shared this story so we can all learn more. I'm thinking you must be pretty uncomfortable having had a sub pec placement, and then having to get a lead adjustment!

I am very impressed with the swift communication of your monitor to the clinic!

May your journey to heal go swiftly from this moment forth. 

What a journey so far

by Gemita - 2024-04-20 04:54:04

Runsalot, welcome to the Club.  You have had quite a journey but from your comments, I am sure little will prevent you from doing what you love.  I am impressed that you have been able to negotiate your settings with your medical team at such an early stage.  I am still trying to do this 6 years on.

I note you have been experiencing a low heart rate with Atrial Fibrillation.  They usually worry more about Atrial Fibrillation with a fast ventricular response, but I know from suffering from both a fast and a slow ventricular response that both extremes can really affect cardiac output and cause difficult symptoms, such as those you have described.  Added to that, the irregularity of rhythm during AF can make us feel extremely unstable, so I am amazed that you have been able to compete in endurance events.  I don’t know how you manage this.

No medical procedure is completely without risk and of course there is quite a lot that “could” happen during a pacemaker implant including a Pneumothorax and Haemothorax.  Although a rare complication following pacemaker implantation, Pneumothorax and Haemothorax can be a consequence of a direct lung or vascular injury during pacemaker lead entry into the axillary or subclavian vein because these veins lie very close to one of the lungs, where there is a risk of the lung being accidentally punctured during the implant procedure as happened to my husband (Haemothorax).

A Pneumothorax is due to an air leak into the space between the lungs and chest wall. This air pushes on the outside of your lung and may eventually cause it to collapse.  A Haemothorax is due to a collection of blood or other fluids in the same space between the lungs and chest wall.  The buildup of blood in this space can eventually cause your lung to collapse as the blood pushes on the outside of the lung.  My husband had to have a drain placed to relieve his symptoms.

Both Pneumothorax and Haemothorax may rarely occur simultaneously. In most cases, any leak is very small and gets better on its own without treatment, but if a lot of air, blood or fluid collects between the lungs and chest wall, this may require chest tube placement and drainage.  

Thank you for your post which is so full of positive thoughts for the future.  I hope you are feeling better and will make steady progress from now on.  What a journey so far  

wow

by Tracey_E - 2024-04-20 11:37:02

What a ride so far! Prayers for smooth sailing from here on out. 

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