HEART DISEASE EXPERT FORUM
Extraction advice needed please

Extraction advice needed please


  Thank you for this valable site, I have used it previously and been given helpful advice. I need some more however. I would like to know about having the ventricular lead repositioned (for the second time in six months). I have persistent pericarditis and the cardiologist feels there is no way out except to move the lead which is either bulging or protruding into the pericardium. This has happened after the first implantation 7 months ago, and the Dr. moved it successfully (he was extremely concerned about doing this as it had not been done before in his or his collegues experience. I have been looking for information on this procedure and what I read at this site is worrying, the fact that the specialist is so concerned and stressed about the whole thing and also has no experience in extraction (this is at St. Vincents Hospital in Sydney - one of the best in Australia for hearts). I am a young mother of three and my family are very concerned. My question is this - can you tell me the procedure for re-positioning, how it is approached, the risks involved and lastly, would I benefit from a trip to the USA to your clinic to see a specialist like Dr. Wilkoff? Is this indeed possible, and what would the costs involve for him to perform this procedure. I realise this is a big ask for you to answer but I am happy to correspond directly with Dr. Wilkoff if that is possible. We feel that the situation warrants caution as I have a very complex problem that the specialists here have no real answers to, and seem to be under pressure. The pericarditis went away immediately the first time the lead was moved (that was only 8 weeks after the initial implantation. The whole lead was removed and replaced with a more flexible one). Medications did not touch the pericarditis as they are not now. I have a very loud, grinding friction rub and constant pain in my chest, which is always worse at night. This started on New years eve. I await your reply so I can have more information to discuss with the specialist on Wednesday next when he will phone me ( I live in the country and he sent me home for a week so he could try to gather more information and come up with a plan). I can get to the States if that is what it takes.
  Thank You,
  Helen Stevens.
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Dear Helen,
I apologize for the delay, however, Dr.Wilkoff is quite busy. The following is
his address and phone number.  First I would recommend that you give him a call,
noting the time difference of course, so that you can tell him a brief history
(basically that you seem to have severe pericarditis that was responsive to
lead position changes in the past.)  That way, Dr.Wilkoff can ask you specific
questions that would help him assess how much care he could provide, or if there
are options not yet considered (this sounds unlikely.)  
You may want to mail a copy of your records to him, so that he can really "know" your case,
so to speak.  
The Cleveland Clinic Foundation
Bruce L. Wilkoff, M.D.
Director, Cardiac Pacing and Tachyarrhythmia Devices
Department of Cardiology/ F15
9500 Euclid Avenue
Cleveland, Ohio  44195
Office Phone (216)444-4975
Fax (216)444-4428
email  ***@****
Good Luck to you and please feel free to write back as needed.





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