ICD lead removal

[vmcmahon]

Hi, I just visited my Doc yesterday to find that ny new ICD is not functioning correctly . He believes it to be the lead is fractured but is not sure. To find out for sure i need to go on the table again. If it is the lead, it needs to be replaced.

I was under the impression that to replace the leads was a simple procedure - relative to changing to ICD that is. however he indicates to me now that it is not so simple and want me to go to montifore to a guy who has a laser who can remove it via laser if there were complications pulling it out.

Has anyone gone thru this of is anyone familiar with this.?

Any input appreciated ASAP as i need to get this done soon

Pls post here or email me at [email protected]
thank you

Vinnie

[Reenie]

Hi Vinnie. Our doctor told us that the lead removal can be tricky because it's actually embedded in cardiac tissue. That must be why your doctor wants someone with a laser to help out with the extraction. I don't know under what circumstances, but sometimes they can leave the old lead in and just insert a new one. You might ask if you would be a candidate for that or not. Good luck.

Reenie

[Lisa Salberg]

Vinnie,
Lead extraction is tricky stuff and the best way currently available is with a special laser procedure. There are many centers with this technology now and you are best to have this done in a center that can provide the best care with the best equipment.
Are you in NYC?

Lisa

[vmcmahon]

lead extraction

Hi Lisa, You probabally do not remember me but i have met you a few times at the wonderful annual meetings which you organise. I am one of your Irish members .

Yes i am in NYC. I currently get treated at westchester medical center in Westchester Co, NY for HOCM and have an ICD also. My ICD doctor wants to send me to Montifore in the bronx to a Dr Jay Gros who has all of the laser equipment to do this.

I was never made aware that it was such a tricky process and i guess was just blindsided with it yesterday. Also the fact that westchester is supposedly such a good cardiac place - the fact that they could not do a removal such as this has not impressed me

What are the complications of the laser - any long term..? does it leave scaring..? how risky is it.? Is there a longer recovery time above and beyond getting a reg icd inplanted..?

Also i want to make sure i get it done in the best place in NYC

Reenie : thank you for your input. I have discussed the option of leaving the lead in there, however i am pretty young and if this were to happen again I would end up with dead Platinum leads lying in my chest.

Appreciate your thoughts
thank you

vinnie

[Lisa Salberg]

Yes I remember you but just wanted to make sure it was the same vinnie!
In NYC Dr. Gros has a great reputation for this procedure. The risk is not "long term" the risk comes in when removing the leads...the laser removes all clots and turns the tissue connected to the end of the lead inton basicly water..thus removing the risk of clots and strokes.
The risk would be to have it removed NOT using the laser.
You can also go to St. Lukes in NYC they have the same equipment.
Best wishes,
lisa

[vmcmahon]

THank you Lisa - I havea consultation on Feb 20 - will let you know how it goes

Vinnie

[Lisa Salberg]

Keep us up dated... I hope all goes well!
Hey I hope to see you again at the meeting this year!
Lisa

[vmcmahon]

hi

well .. i am glad to report that all went well with the "explant" and i am home and feeling great. High Praise to Dr Gross and his team of wonderful people - their dedication and passion is amazing....

[Reenie]

I'm glad everything went so well. Take time to rest and recuperate.

Reenie

[Karen P]

Hi Vinnie,

I'm glad all went well! Which hospital is Dr. Gross of of in New York?

Karen

[vmcmahon]

Dr Gross is in the Montifore medical center.. in the bronx in NY.. their unit is highly renowned for cardiac pacing treatment and EP... vinnie

[Karen P]

Thanks Vinnie!

[Cynaburst]

Hi Vinnie,

I am curious...would you mind describing the procedure. Were you sedated or under a general anaesthesia. Did they replace the leads at the same time? How impaired were you afterward? How does it compare with implantation?

I am just curious because I just got my first ICD a week ago, so I won't need this anytime soon, but if they ever develop an MRI safe ICD, I would probably have to have my leads replaced, so I am just curious what is involved.

[Lisa Salberg]

Hi Vinnie,
I am just back from vacation and saw that all went well with the explant!
I know you had get care for this procedure and am glad to hear your back in action...you know St. Pats is just around the corner!
Best wishes!
Lisa (Flanigan) Salberg

[JR]

Hi, my name is JR. I received my ICD on 10/20/2000. Up till now everything has been running smoothly. I was out of town a week ago and suddenly felt lightheaded and out of breath. The feelings did not go away and the next day the ICD beeped. I called the Dr. (on a Sat.) and no one called back. so I returned home and went to see what was up.

The pacemaker lead wire has malfunctioned or disconnected. Shock lead wire is intact and operative. Since this requires yet another trip to the chamber of horrors (I wasn't medicated enough when ICD was being tested. I have graphic memories of cardio and defib shock testing, as well comments made to the Dr. and staff during the procedure, but I digress) a decision will made in concert with a medtronic technician as to whether to replace the battery (currently at 2.6v, and 2.5 v signifies time to repl. battery). Hopefully battery replacement isn't a big deal. I'd like them to change it so I won't have to go in yet again, in the months (1 year or so) to come. This is merely background fodder. My missive is as follows:

I have been feeling pretty uncomfortable due to my IHSS (with obstruction) being back in full unmediated bloom. With the constant pacing, which keeps the gradiant at around a 6-8 vs 155-170, I was told the earliest I would return was 3 years. This remains true had it not been for the ol lead disconnect/malfunction syndrome of late.

The Dr. said he will either A.) Re-connect or B.) Extract the lead wire and replace. He made no comments as to the particulars and pitfalls inherent in the extraction process.

I go in on Wed. 19th. I thought I'd sniff the usual web sites for anything unusual pursuant to the procedure. Wowsers! Was I surprised. Now I am a bit wigged out about it all. Forgive my kvetch, but I've been thru my share of heart ops these past 6 yrs. and I must say, this looks like it could be as much fun, perhaps even more, than the last. The ICD operation was shockingly (no pun intended) painful and they left me in the hosp. for 2 days without pain meds. Youch! It was the weekend and the Doc wasn't sure what was required till he went in. I got up, waived goodbye, went home to watch the World Series. Unreal! By Monday it was raining percocets.

I am concerned and perplexed I wasn't alerted that extraction is a step up from the usual. I am always a gentleman, self efacing and graceful in the staff's presence. I never whine to them, but I must say I wasn't prepared for the revelations I gleaned tonite.

While it is true that extraction may NOT occur, my luck pretty much keeps me in a mindset to plan for the worst and be surprised if the punishment is less.

Thank you for this forum to verbosely vent and, yes, ... whine. Any insights or perspectives would be appreciated. I do plan on mentioning this matter to the Dr., in passing, before the nurse's razor clutching hand begins flailing at my chest and abdominal hair.

I've been walking around all week thinking this was mostly an inconvenience. Ignorance is bliss. As Gomer Pyle would say, "Surprise!, Surprise!, Surprise!". Indeed.

JR