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Heart Disease (Expert Forum)
Surgery or not?
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve Prolapse, Pacemaker, PAD, Stenosis, Stress Tests.
Surgery or not?
by TCN, May 25, 2007 12:00AM
Thank you for your time. I am a 39yr.f. I have complete heart block, as result of an av node ablation. The beginning of April I had a new pacemaker put in. I also have SVC syndrome, so the goal was to remove my ventricular lead before putting in a new one.
The docs. where I live no longer have access to laser removal, so the cardio-thoracic surgeon tried with no success. Now I have an infection. 2 days after surgery I had a temp.of 101.5 They sent me home anyway. I was back in the hospital one day after release with a higher fever. Cultures came back neg. lg. hematoma.
Since then the site has split apart, drains and bleeds. My EP, who has gone through a prior pacemaker infection with me thinks this needs to come out. The cardio-thoracic surgeon thinks it will probably be ok, and wants to wait til high fevers come back and cultures are positive. As I said I had a prior infection. At the point lasers were used to remove the whole system to the other side. This infection looks identical.
My EP wants me to go to Boston for removal, and my the surgeon says no.
Questions:
Should I wait til I am sick to get the pacer replaced?
What major center in Boston would you recommend?
It was discovered I have no underlying rhythm. Does that mean if my pacer died, I would have no chance?
I went into complete pulmonary edema prior to spinal surgery. Is that congestive heart failure?
What course would you recommend for me. I am on Keflex, and have been for weeks.
The docs. where I live no longer have access to laser removal, so the cardio-thoracic surgeon tried with no success. Now I have an infection. 2 days after surgery I had a temp.of 101.5 They sent me home anyway. I was back in the hospital one day after release with a higher fever. Cultures came back neg. lg. hematoma.
Since then the site has split apart, drains and bleeds. My EP, who has gone through a prior pacemaker infection with me thinks this needs to come out. The cardio-thoracic surgeon thinks it will probably be ok, and wants to wait til high fevers come back and cultures are positive. As I said I had a prior infection. At the point lasers were used to remove the whole system to the other side. This infection looks identical.
My EP wants me to go to Boston for removal, and my the surgeon says no.
Questions:
Should I wait til I am sick to get the pacer replaced?
What major center in Boston would you recommend?
It was discovered I have no underlying rhythm. Does that mean if my pacer died, I would have no chance?
I went into complete pulmonary edema prior to spinal surgery. Is that congestive heart failure?
What course would you recommend for me. I am on Keflex, and have been for weeks.
Doctor's Answer
by Forum-M.D.-MJM, May 25, 2007 12:00AM
Hello,
I am sorry to hear about your infection. Pacemaker infections are very complicated.
Should I wait til I am sick to get the pacer replaced?
Most pacer infection require extraction. If you are confident that the pacer was infected at some point, it is probably still infected. Antibiotics are not very successful at treating infection on hardware like pacemakers, ICD or leads. If it is infected, it needs to come out.
What major center in Boston would you recommend?
I do not know which center is Boston does laser extractions. Bruce Wilkoff here at the Cleveland Clinic specializes in pacermaker/ICD extractions -- he is very good and I would give him my highest recommendation. There are probably very good people in Boston, I just don't know them.
It was discovered I have no underlying rhythm. Does that mean if my pacer died, I would have no chance?
It depends on how they checked it. No one will let you go more than a few seconds without pacing. There is chance that if you waited 10 seconds without pacing that you would have an escape rhythm.
I went into complete pulmonary edema prior to spinal surgery. Is that congestive heart failure?
I would need more information to say. If you otherwise have a normal heart, I doubt it was congestive heart failure. It could have been a drug reaction.
What course would you recommend for me. I am on Keflex, and have been for weeks.
Your need a second opinion in the office of someone that does extractions. You need to come off your antibiotics and if you spike fevers again, the device and leads need to come out.
I hope this helps and that you are back to normal soon. Thanks for posting.
I am sorry to hear about your infection. Pacemaker infections are very complicated.
Should I wait til I am sick to get the pacer replaced?
Most pacer infection require extraction. If you are confident that the pacer was infected at some point, it is probably still infected. Antibiotics are not very successful at treating infection on hardware like pacemakers, ICD or leads. If it is infected, it needs to come out.
What major center in Boston would you recommend?
I do not know which center is Boston does laser extractions. Bruce Wilkoff here at the Cleveland Clinic specializes in pacermaker/ICD extractions -- he is very good and I would give him my highest recommendation. There are probably very good people in Boston, I just don't know them.
It was discovered I have no underlying rhythm. Does that mean if my pacer died, I would have no chance?
It depends on how they checked it. No one will let you go more than a few seconds without pacing. There is chance that if you waited 10 seconds without pacing that you would have an escape rhythm.
I went into complete pulmonary edema prior to spinal surgery. Is that congestive heart failure?
I would need more information to say. If you otherwise have a normal heart, I doubt it was congestive heart failure. It could have been a drug reaction.
What course would you recommend for me. I am on Keflex, and have been for weeks.
Your need a second opinion in the office of someone that does extractions. You need to come off your antibiotics and if you spike fevers again, the device and leads need to come out.
I hope this helps and that you are back to normal soon. Thanks for posting.
Member Comments (3)
by wurdy, May 28, 2007 12:00AM
To: ablation
I have just been diagnosed with AFib. I see the cardiologist in 2 weeks. What should I expect at my first appt. What is an ablation.
by sarasotaconnie, Jul 22, 2007 12:00AM
I am a 76 year-old female in good health who recently had a chest CAT to verify that “walking pneumonia” was gone. It revealed enlarged heart. Have NO heart symptoms. Cath #1 revealed 2 blocked arteries: Distal left main stem and osteo left anterior descending. IVUS cath showed 68% blockage. Cardiologist claimed because of location of distal, he couldn’t readily do stent or angioplasty and said I need bypass. Primary said to investigate tPA at Cleveland. Would I be a candidate? What would this entail? Can I have it done in Sarasota FL? Any other alternatives?
