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Lead Dislodgement
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Lead Dislodgement

Hi - my husband had a dual chamber pacemaker implanted 2 days ago for Sick Sinus Syndrome (with 2 to 4 second pauses) and Atrial Fibrillation. After the procedure, we were informed that it was difficult to place the leads becasue my husband has a mildly enlarged heart. The night after the procedure his diaphragm was twitching in synchrony with his pulse. After reviewing a chest x-ray and testing the pacemaker, the electrophysicologist deactivated the atrial lead (via programming) because it was partially dislodged which was causing it to fire irregularly and only at high levels - this was what was causing the diaphragm twitch. The electrophysiologist explained that the atrial lead targeted Atrial Fib and was primarily for quality of life, whereas the ventricle lead was targeting bradycardia and pauses. He recommended that my husband have a second surgery to have the lead repositioned. My husband is reluctant to have another surgery when it is only for quality of life and is wondering whether it is worth it, or if he can leave opt not to have surgery and leave the atrial lead deactivated.
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Hi, I am very sorry to hear of the problems that your husband has encountered.I have had an ICD for 6 months now. If it were me, my first and biggest concern would be to find out more about the 'dislodged ' lead. The leads are 'screwed' into heart muscle, so it is imperative to find out if it was 'pulled' out somewhat. As you know from post instructions, it is important not to lift left arm, and particularly not strain it.
  I would want to make sure that the tissue is not subject to tearing, leading to dangerous complications.
  To be honest, I would want a second opinion, and want it corrected. I can sympathize with your husband's suffering, as I have been zapped out of VT. But for peace of mind, I would opt to have it corrected.
  I wish you well and for swift resolution. -  Steve
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Avatar_m_tn
Thanks so much for the info - we will be talking to the cardiologist tomorrow, so I will make sure to ask about the pulling and possible tearing. Definitely want a second opinion, to make sure a second attempt has the best chance of success. Alison.
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