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Lead Extractions

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LloydS Find out more about LloydS
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  • Lead Extractions

    I have had a box for nearly 11 years now. After a couple of new batteries, the last surgery I woke up without a box - just the old leads were left in. Because of the age of my first box, the implant was done in the stomach, not in the chest. After many follow up appointments with the best doctors (Dr. Maron - Minneapolis, Dr. Lever and Dr. Wilkoft - Cleveland), everyone believes I do need a new box, and a full new set of wires.

    I have studied lead extractions through the net. What I have found is that leads are only meant to last about 7 - 10 years. That means the younger someone is, they are really going to have some kind of life experience with this particular event/surgery.

    I am planning on have the extraction done at Cleveland. Does anyone have experience with their leads being extracted?

    Thank you in advance for any information.

  • #2
    Re: Lead Extractions

    The technology that is now available makes the procedure far safer than in the past. I too have a set of leads that are now 12 years old (but mine are in the upper chest).
    I know Cleveland has the laser equipment that is the best for lead removal and that you are in good hands.

    Be well,
    Lisa
    Knowledge is power ... Stay informed!
    YOU can make a difference - all you have to do is try!

    Dx age 12 current age 46 and counting!
    lost: 5 family members to HCM (SCD, Stroke, CHF)
    Others diagnosed living with HCM (or gene +) include - daughter, niece, nephew, cousin, sister and many many friends!
    Therapy - ICD (implanted 97, 01, 04 and 11, medication
    Currently not obstructed
    Complications - unnecessary pacemaker and stroke (unrelated to each other)

    Comment


    • #3
      Re: Lead Extractions

      Lloyd,
      Thanks for scaring the crap out of me..JK . Mines a little over ten years old, and I just had another battery replacement in June. They said my leads were still fine, hopefully for a couple more years. A question I have for Lisa is..If or when I need to get mine extracted, is there any place in this neck of the woods that does that? Currently I go to Mass. General for my ICD.

      Bryan

      Comment


      • #4
        Re: Lead Extractions

        Now it's my turn for a question.... When my husband got his ICD they said (at the time) that they usually don't remove wires to replace them, they usually just thread new wires in and leave the old ones. Is that old technology or is that still the preferred way to do things unless the veins are too small to accomodate more wires?

        Reenie
        Reenie

        ****************
        Husband has HCM.
        3 kids - ages 23, 21, & 19. All presently clear of HCM.

        Comment


        • #5
          Re: Lead Extractions

          Reenie,
          I thought I was told the same thing. I thought they said all they do is "cap" them. But I thought maybe now they just remove them. intresting question!!

          Comment


          • #6
            Re: Lead Extractions

            It's an individual thing. Reenie is right about sometimes needing more space in a small vessel. As the technology improves, we may likely be seeing more removals of older leads, but we will also see improvements in the leads themselves with a longer use expectancy. In the past , they were capped and left in unless there was a specific reason to remove. Depending on the doctor's experience, some will be more likely to remove leads than other doctors would. Don't be afraid to question your doctor about his/her previous experience/competence. Part of the ICD interrogation is evaluation of the leads, so the docs are watching that part of the equipment very carefully also. Linda

            Comment


            • #7
              Re: Lead Extractions

              I am going to Cleveland for the lead extractions. What I have been told is it depends on your age (or if there is an infection) if they need to remove.

              Since I am 41, and considering the leads only last around 10 years, I really need to have them removed, otherwise, God willing, I live to 80+ I would way too many veins going into the heart filled.

              They do have awesome experience and great results at Cleveland with lead extractions. They tell me the success of getting the leads out depends on a couple of factors; how long they have been in you (shorter the better), how good the doctor was in putting them in, and what experience the doctor has. I am still curious if any one in this forum has had it done. I am still nervous about the whole thing.

              As any FYI, my leads were the Medtronic 6963 and 6966.

              I did'nt mean to scare ya'll - it is just a frustrating reality living with these systems, and I believe we are all going to need to understand this issue in a better way, very soon.

              God Bless

              Comment


              • #8
                Re: Lead Extractions

                LloydS, you didn't scare us. You raised a very valid question. I'm really glad you asked. You're right, I'm sure that Cleveland is one of the best places to have this done. I was just wondering out loud about my own husband. His leads have only been in for 3.5 years at this point, so we aren't worried about replacing them yet, but it's something we may have to think about down the road. And an extraction might be in order for him. When they were placed the doctor had to use a different vein than he usually uses because the subclavien vein (I think that's the one he usually used) was too small. That makes me wonder about the one he did use. Know what I mean? Thanks for bringing this up!

                Reenie
                Reenie

                ****************
                Husband has HCM.
                3 kids - ages 23, 21, & 19. All presently clear of HCM.

                Comment


                • #9
                  Re: Lead Extractions

                  I had to have just one malfunctioning lead replaced 9 months ago. They were able to just leave the old one and thread in a new one. But with all my wires we are really having fun threading lines in for PIK and when I had my swans line in in Jan. I would think a whole new set of leads you would need the old ones pulled. But laser technique is so much better than the old way.
                  Midge

                  Diagnosed in 1977, Myectomy in 1981 @ Mayo Rochester
                  ICD&Pacemaker 1996
                  Heart transplant March 19, 2004 @ Mayo Rochester
                  Mom of Kaye.

                  Comment


                  • #10
                    Re: Lead Extractions

                    my e.p in los angeles told me that leads these days last several generations of the i.c.d's and that they're getting thinner and thinner. as such she prefers to just lay new leads next to the old ones and only extracts if there's a real good reason: infection etc.

                    perhaps this is a question of how old/big the original leads are--i'm guessing the older they are the larger they're likelier to be--and the knowledge base of the center in question. i don't have any direct experience with cleveland but i think i'd trust anything they told me.

                    Comment


                    • #11
                      Re: Lead Extractions

                      Monjo hit it - it really is an issues that is very individual. I tend to have small viens - therefore IF I were to ever need a new lead I have been told the old ones must come out (one or 2 of them likely - I currently have 3 leads in).

                      I will be looking at a new device in the next year or so - IF all is well with the leads at that point --- then we "let sleeping dogs lay" - if I need a new lead - well thats a "horse of a differnt color".

                      Bryan - I do think there is somewhere in Boston that can do it - maybe NEMC?? I have to check.

                      Be well all!
                      Lisa
                      Knowledge is power ... Stay informed!
                      YOU can make a difference - all you have to do is try!

                      Dx age 12 current age 46 and counting!
                      lost: 5 family members to HCM (SCD, Stroke, CHF)
                      Others diagnosed living with HCM (or gene +) include - daughter, niece, nephew, cousin, sister and many many friends!
                      Therapy - ICD (implanted 97, 01, 04 and 11, medication
                      Currently not obstructed
                      Complications - unnecessary pacemaker and stroke (unrelated to each other)

                      Comment


                      • #12
                        Re: Lead Extractions

                        What a great forum. I have literally been myself, living with HCM and my box for 11 years. I have not told my children, nor my employer. Only my wife and parents have real knowledge.

                        Lisa, Thank you!

                        I also want to thank those of you responding to the lead extraction questions. It helps to at least be able to discuss these types of questions with a 'team' that 'gets it'!

                        I am sure I will back another day! Until then, take care!

                        Comment


                        • #13
                          Re: Lead Extractions

                          lloyd

                          your children must get annual echos to see if they have hcm too. how you accomplish this without telling them what they are looking for depends on how old they are, but it can be done.

                          s

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                          • #14
                            Re: Lead Extractions

                            boy what a touchy subject. Leads and tips that have been in for a while will get fibrotic, in other words the heart muscle and the veins they travel through will tend to grow over and around them. That is why they prefer to leave them in. Should you get a blood stream infectionthey have to come out immeadiately, and if tou are someplace that does not have the laser, they have to pull them out. When they do this there will be loads of bacteria living on the leads which will be thrown into the wind(bloodstream) so to speak and travel all over the body. This is exactly what happened to my son last july and 7 months later now he is still in the hospital. They had to implant a new icd with epicardial leads 2 weeks ago and some how got another infection but they do not know where or what from. His surgery was open heart and 4 1/2 hours long and I will not bore you with the details but I am FURIOUS at the doctors. We tend to think that a defibulator is sund a minor procedure, mine was, but the complications can be devasting and this we don't get told. if you can not get to a laser for extraction and there is no infection I would leave them alone. Thanks for listening,
                            Art

                            Comment


                            • #15
                              Re: Lead Extractions

                              Complications are the downside to all procedures. I know Art and his family have been through **** this year. I think it is important to note that in this case the young man has had several appropriate ICD shocks and was implanted after a cardiac arrest.
                              We all need to be aware that these procedures do have risks and must be entered into with care.

                              Best to all,

                              Lisa
                              Knowledge is power ... Stay informed!
                              YOU can make a difference - all you have to do is try!

                              Dx age 12 current age 46 and counting!
                              lost: 5 family members to HCM (SCD, Stroke, CHF)
                              Others diagnosed living with HCM (or gene +) include - daughter, niece, nephew, cousin, sister and many many friends!
                              Therapy - ICD (implanted 97, 01, 04 and 11, medication
                              Currently not obstructed
                              Complications - unnecessary pacemaker and stroke (unrelated to each other)

                              Comment

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