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depotdoug, February 27,  2021  12:40pm EST

"RA" right atrial lead revision scheduled-Mon March 01 EP Lab# 1. Insert new 2021 St Jude pacing lead.

Good afternoon AFIB support friends,

Life's next medical challenge awaits Depotdoug this nex Monday @ 1:00PM. I receive a new RA pacing lead inserted down to my right Atria. So, my 9yr 10 mon old St Jude Med Durata pacing lead was identified with noise the past year, with an incresing threshold of chronic noise. Discussion this Monday with my 5th yes 5th EP doctor went through the procedure protocol, sounds easy enough, with the caveat of NOT extracting my 'old' fractured, aging pacing lead. Ok, the terminology they use for that procedure is Debulking. Sounds mechanical. 

But the procedure of extracting(laser) old embedded pacing or defirillating leads can be invasive and cause more damage than leaving lead intact. Ok, my question is? Will my old lead interfere with or get in the way of my new RA lead in any way?

Anybody here ever had a RA pacing lead revision and or extraction?



5 Replies
  • AHAModerator
    AHAModerator, February 28,  2021  1:49pm EST

    Hi Doug,

    Thank you for reaching out to the MyAFibExperience community. I can imagine how difficult and confusing this must be and I hope you will be able to connect with others who have gone through or are currently going through a similar experience. Unfortunately, I am not a medical professional, and questions this specific should always be put to a cardiac care team.

    Please keep us updated with how you are feeling!

    Best Wishes,

    AHA Moderator

  • depotdoug
    depotdoug, February 28,  2021  2:19pm EST

    AHA Moderator, Katie, Mellanie,

    Understand that reasoning, absolutely and my questions concerns have been given, and answered for the most part. I was really wondering if any of my/our AFIB pacemaker device monitored friends have had the same procedure performed. Yes my AFIB recovery was helped tremendously by my RF cath ablation May 2020. Now NSR days = 298!

    Love NSR. There is so so much support abd encouragement here that I hope some chime in with their experience. Not medical necessarily, but how was the experience.  I had my 1st ICD/pacemaker implanted May 17,2011 5 days post SCA. Still with original well worn RV and RA leads.  Pacing and AFIB rhythm control, that would be an interesting topic. 
    It kind of let me down when my super AFIB RF catheter ablation EP doctor left his EP group suddenly a couple weeks ago.  
    Thanks for supporting all of us.


  • MellanieSAF
    MellanieSAF, March 2,  2021  11:29am EST


    I was thinking of you Monday, but was restoring my computer so was not able to get here.

    How did it go? How are you doing?

    If there was any likely interference, I would think your EP would probably not leave the lead in as he would have to deal with that for years to come.


  • depotdoug
    depotdoug, March 2,  2021  12:36pm EST

    Mellanie, How coincidental that you responded now. 

    1st of all I am doing very well, saying that with enthusiasm and relief. MY RA lead revision procedure was supposed to start @ 13:00 but was pushed out till 14:30, with just ~ 90 min procedure, including prep/set-up. Dr Rodriguez was excellent in answering all, I mean all my questions. He exclaimed that if there was any, any interference or fracturing from my 9y 9m old Durata St Jude Med lead they would have not even continued. That did not happen. I had the best experience in EP lab #1 than I ever had, excluding my RF cath ablation May 2020. NSR rocks now 300days 5hr. 

    My left shoulder and upper right arm is sore at incision site but bearable. That feeling will subside. 

    Back to my noisy, fractured RA old lead. It was amazing for Dr R. to assure me that there would be no interference from my old lead, plus he and the EP lab RN's, and the St. Jude med tech were on it all the time. I mean X-ray and dye injection flouroscope scans showed extremely detailed images of my heart inside and out. I was excited to actually see those Heart Scans before I was consciously sedated. Both original RA and RV leads were inserted threaded through that main artery to my heart. Ok, was there room for a 3rd? That is what actually happened 3 leads in one artery, ok. 

    Add this, I had an excellent conversation with my St. Jude med tech rep, Kip before and during my RA lead proc. When he interrogated my ICD/pacemaker in Pre-op he was so attentive a listener to me plus he actually showed me the "noise" status on my old RA lead. And he asked me to me squeeze my hands together, like lifting something heavy or shaking someones hand firmly. my RA lead was spiked and visible on his St. Jude Monitor. Amazing. Then I asked Kip if I hit(smack) my hand with my other would the RA noise duplicate? He said do it. I Noise was even stronger.. 
    Finally do I have any regrets about not extracting my old RA lead,No. I asked Dr Rodriguez and Kip if/when Lead extraction could be done when my next ICD/Pacemaker gen change is due? They both said yes! 

    Thanks for asking about me Mellanie,


  • MellanieSAF
    MellanieSAF, March 3,  2021  10:00am EST


    I'm glad you're doing well since your procedure.


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