AICD Leads

[HCMBetter]

I am 34yr-old non-obstructive Hypertrophic Cardio Myopathy patient with Medtronic AICD. It is my second device, had it since 2002. My first device was Guidant in 1996. My first device expired, not because of battery but because my lead shocked me after 5 1/2 years, and was deemed no good. I never found out if it was a bad lead, or whether I wore down the lead, because I am a lefty, and from 22 to 28 I was very active, throwing motions, punching motions, sports, in the gym, etc. I have heard the leads can wear faster on younger more active people. Now I am replacing my Medtronic device, and I am wondering if I should get new leads while Im under. Because I don't want to get shocked or replace my leads before I get my next device in another 6 or so years. Yet, they say not to replace your leads unless if it is necessary because lead extraction is very difficult and more risky. So my basic question to those of you with experience with your devices is, WHAT IS your experience? Are the Medtronic leads real durable? Should I leave them in if they test out okay in the lab? Or should I change them now, while Im undergoing the procedure? Thanks.

[Bromley]

I think you should do as much research about your lead and about lead replacement before making any decisions. You never found out why your lead shocked you.  How do you know there is anything wrong with it?  Also, isn't the ICD replacement straight forward (i.e. no real big deal?) whereas the lead replacement is a very big deal?  If so, I think it makes more sense to wait and go through a second procedure when and if it becomes necessary, or starts to look like it will be necessary.

[HCMBetter]

My current lead is fine. That's not the issue. It will likely test well in the lab when I get the new ICD. The issue is that it could wear 2 or 3 years in, and may need replacment. And they can't tell that in the lab. So instead of going for surgery for a new ICD in another 6 years, I will be back in the hospital in 2 or 3 years getting a lead extractred. So ultimately my question again, to anyone with multiple ICDs and leads in their history, is...

...what's your experience? Are the leads durable, up to 12 or so years, so I could wait until my next ICD? Or do they wear and need replacement? Because if they do wear, then I will change them now, while Im under for this next procedure.

[kevk]

My leads are 17 years old.  Your leads can wear if you get a lot of therapy.  I have had 4 ICD`s since 1991.

I have the older medtronic leads connected to the outside of my heart. ( These leads can never be removed).  My thinking is if it`s not broken do not fix it.