any tests can be done before lead revision?

If your EP suspects you may have a lead fracture, did your EP give you any test before doing lead revision or replacement , such as chest xray or echo or Fluoroscopy?  Or just simply based on the interrogation report alert?

 

I want to know if there are any tests available to evaluate the urgency to fix the lead. 

 

Thanks


5 Comments

So many posts from you

by Gemita - 2024-09-29 06:05:50

Smopace, I am one of the moderators here. I have noticed an ever increasing number of posts from you which are taking over our home feed page and causing some upset to our members.  We seem to be going around in circles trying to answer your questions, with no conclusion in sight about whether your father has a faulty lead or not, what might be causing it and whether there is some urgency to get it fixed? 

Could you kindly try to keep the sheer number of your posts down a little, so that other members will not feel so overwhelmed by seeing so many messages from you.  There will be plenty of time to continue to ask your all important questions in the future prior to, and when you have received a second opinion.  Thank you for your understanding with this.  

I will now attempt to answer your last and current post in my separate comment below.

Symptoms of the patient

by Gemita - 2024-09-29 06:10:38

Smopace, I would imagine the most important test of all to evaluate whether there is an urgent need to fix a “potential” malfunctioning lead due to a fracture or other cause, would be to assess the symptoms of the patient.  As far as I am aware, you have always said that your father does not have any symptoms and that there appears to be no urgency to fix the lead.  

If the patient is free from symptoms as your father seems to be, then they may not need to fix anything quickly and may just watch and wait.  You mentioned in a comment that your doctor is aware of the trigger for the lead noise (?movement of the arm?).  However, I am still unclear whether your father has a failing lead or not, particularly in the absence of symptoms and lack of any real urgency from your doctors to get this problem fixed.

Your previous post provided us with pacemaker data and claimed that you have finally found the reason why your doctor thought your father's pacemaker may have a lead issue.  I would respectfully ask you one important question.  Do you actually believe your doctor’s assessment that your father has a faulty, fractured pacemaker lead?  From your posts, you still appear to be trying to establish whether the information your doctor has given, is accurate? 

I have always found Medtronic to be very helpful in answering general technical questions about their specific device settings.  You could ask your local Medtronic office representative some questions.  However when I have tried to ask about my own personal pacemaker settings, they will always refer me back to my own pacemaker care team who will obviously know my condition best, so you could try to ask your father’s pacemaker clinic technicians your specific questions?   I would do so and try to get confirmation of the significance and accuracy of the SIC (sensed impedance change) of more than 300 figure in determining whether it really confirms a faulty lead or whether it could be caused by other factors which might result in an “inappropriate” increase in the SIC figure?  

There are a number of tests available to evaluate the urgency to fix a faulty pacemaker lead, particularly if a patient complains of symptoms like over stimulation somewhere causing vibrations, or a loss of stimulation resulting in severe symptoms like syncope, breathlessness.  Fractures and other faults may be detected by conducting lead impedance tests and can also be confirmed by X-ray.  

I would wait patiently for a second opinion which I see will happen within the month when hopefully you will receive all the reassurance you deserve.  In the meantime, keep watching out for symptoms and report any changes immediately to protect your father from "potential" harm.

interrogation

by Tracey_E - 2024-09-29 08:56:46

The interrogation report will tell them all they need to know.

Thank you for your comment gemita.

by smopace - 2024-09-29 18:47:44

I will keep my message to the minimum. I don't realize there is such as rule. But I will follow the rule. I appreciate all the responses I got from the group and I got a lot of knowledge about pacemaker from this group. Also thank you for spending time writing long message to calm me know. 

 

Smopace, thank you again for your understanding.  

by Gemita - 2024-09-30 04:04:25

If we have multiple things to say that are on the same topic, these should ideally be placed under the original post rather than creating multiple posts on the same subject.  I accept however that newer comments may not always be seen as our messages drop down the Most Recent Messages board.  It is hoped that we will soon have a new feature available to correct this problem. 

As you may know, we will be getting an upgraded Pacemaker Club with many new features fairly soon.  It is hoped that when we add new comments on the same subject to any of our recent or older threads, that these comments will automatically go (be bumped) to the top of the Most Recent Messages board where they will be readily seen.  In this way we won’t have to start so many new posts on the same subject and take over the daily Pacemaker Club feed.  

In the meantime, please don’t be afraid to post.  We value all posts, including yours

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