What is Fractured Pacemaker Lead Replacement
The most common cause of a pacemaker malfunction is a broken (fractured) lead. Leads, also called electrodes, are made of one or two wires that are separated and covered with insulation.
The wires or the insulation can break, or the contact point in the heart can stop responding to the spark from the pacemaker. When this happens, the lead must be replaced.
Tell a health care provider about:
- Any allergies you have.
- All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
- Any problems you or family members have had with anesthetic medicines.
- Any blood disorders you have.
- Any surgeries you have had.
- Any medical conditions you have.
- Whether you are pregnant or may be pregnant.
What are the risks?
Generally, this is a safe procedure. However, problems may occur, including:
- Piercing (puncturing) a lung.
- Blood clotting in the vein that is used.
- Another lead malfunction.
- Infection.
- Bleeding.
- Allergic reaction to medicines.
- Damage to other structures or organs.
- Fluid buildup around the heart or lungs.
What happens before the procedure?
- Follow instructions from your health care provider about eating or drinking restrictions.
- Ask
your health care provider about:
- Changing or stopping your regular medicines. This is especially important if you take diabetes medicines or blood thinners.
- Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do nottake these medicines before your procedure if your health care provider instructs you not to.
- Your pacemaker will be evaluated. You may have a chest X-ray.
- Plan to have someone take you home from the hospital or clinic.
What happens during the procedure?
- To
lower your risk of infection:
- Your health care team will wash or sanitize their hands.
- Your skin will be washed with soap.
- Hair may be removed from the surgical area.
- An IV tube will be inserted into one of your veins.
- You
will be given one or more of the following:
- A medicine to help you relax (sedative).
- A medicine to numb the area (local anesthetic).
- A medicine to make you fall asleep (general anesthetic).
- An incision will be made in your chest, typically at the scar from the pacemaker implantation surgery.
- The fractured lead will be unscrewed from the pacemaker. There is usually an effort to remove the broken lead. Sometimes this is too difficult or dangerous, so the fractured lead may be left in place.
- A new lead will be moved through a vein with the use of X-ray images. The lead tip will be positioned into the heart muscle.
- The other end of the lead will be attached to the generator.
- Your incision will be closed with stitches (sutures) or germ-free (sterile) tape.
- A bandage (dressing) may be applied over the incision site.
The procedure may vary among health care providers and hospitals.
What happens after the procedure?
- Your arm on the side of the procedure should notbe raised higher than your shoulder for at least 5 days, or as long as directed by your health care provider. Except for this restriction, continue to use your arm as normal to prevent problems.
- Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
- You may have chest X-rays to check the new leads.
- Do notdrive for 24 hours if you received a sedative.
Summary
- The most common cause of a pacemaker malfunction is a broken (fractured) lead, which must be replaced.
- Before the procedure, ask your health care provider about changing or stopping your normal medicines.
- Your arm on the side of the procedure should not be raised higher than your shoulder for at least 5 days, or as long as directed by your health care provider.
Fractured Pacemaker Lead Replacement, Care After
This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.
What can I expect after the procedure?
After your procedure, it is common to have:
- Mild discomfort at the incision site.
- A small amount of drainage or bleeding at the incision site. This is usually no more than a spot.
Follow these instructions at home:
Incision care
- Follow
instructions from your health care provider about how to take care of your
incision. Make sure you:
- Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
- Change your dressing as told by your health care provider.
- Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do notremove adhesive strips completely unless your health care provider tells you to do that.
Check your incision area every day for signs of infection. Check for:
- More redness, swelling, or pain.
- More fluid or blood.
- Warmth.
- Pus or a bad smell.
Electric and magnetic fields
- Digital cell phones should be kept 12 inches (30 cm) away from the pacemaker when they are on. When talking on a cell phone, use the ear on the opposite side of your pacemaker.
- Do notplace a cell phone in a pocket next to the pacemaker.
- Household appliances do not interfere with modern-day pacemakers.
Medicines
- Take your antibiotic medicine as told by your health care provider. Do notstop taking the antibiotic even if you start to feel better.
- Take over-the-counter and prescription medicines only as told by your health care provider.
General instructions
- Do notraise the arm on the side of your procedure higher than your shoulder for at least 5 days, or as long as directed by your health care provider. Except for this restriction, continue to use your arm as normal to prevent problems.
- Do nottake baths, swim, or use a hot tub until your health care provider says it is okay to do so. You may shower as directed by your health care provider.
- Do notlift anything that is heavier than 10 lb (4.5 kg), or the limit that your health care provider tells you, until he or she says that it is safe.
- Return to your normal activities after 2 weeks, or as told by your health care provider. Ask your health care provider what activities are safe for you.
- Keep all follow-up visits as told by your health care provider. This is important.
Contact a health care provider if:
- You have more redness, swelling, or pain around your incision.
- You have more fluid or blood coming from your incision.
- Your incision feels warm to the touch.
- You have pus or a bad smell coming from your incision.
- You have a fever.
- The arm or hand on the side of the pacemaker becomes swollen.
- The symptoms you had before your procedure are not getting better.
Get help right away if:
- You develop chest pain.
- You feel like you will faint.
- You feel light-headed.
- You faint.
Summary
- Check your incision area every day for signs of infection, such as more fluid or blood. A small amount of drainage or bleeding at the incision site is normal.
- Do not raise the arm on the side of your procedure higher than your shoulder for at least 5 days, or as long as directed by your health care provider.
- Digital cell phones should be kept 12 inches (30 cm) away from the pacemaker when they are on. When talking on a cell phone, use the ear on the opposite side of your pacemaker.
- If the symptoms that led to having your lead replaced are not getting better, contact your health care provider.
