What happens when one of my ICD leads is turned off?
The effect of turning off a lead depends on which lead it is and what function it was providing. ICDs can have between one and three leads, each connected to a different chamber of the heart or serving a different purpose.
A lead may be turned off because it is no longer functioning correctly, because it is causing inappropriate sensing or therapy, or because a new lead has been added to replace its function. In some cases a lead is left in place but deactivated rather than removed, as lead extraction carries its own risks.
Whether the device can still deliver full therapy after a lead is turned off depends on the configuration. If the defibrillation lead is unaffected, the device can still deliver a shock when needed. If a pacing lead is turned off, the device may pace less effectively or not at all in certain situations. Your cardiologist will explain exactly what the change means for your individual device programming and what, if any, additional monitoring or precautions are needed.
If a lead has been turned off and you are unsure what that means for your protection, ask your ICD clinic directly. You are entitled to a clear explanation of how your device is currently configured and what it will and will not do.
Category: Implantable DevicesWhat is a lead perforation?
Lead perforation is a potential complication occurring rarely in heart device implant procedures. It occurs when a lead pokes through the heart wall instead of embedding into the heart wall muscle.
Category: Implantable DevicesHow are the leads attached to my heart?
ICD leads are thin, flexible wires that carry electrical signals between the device and the heart. During the implant procedure, the surgeon threads one end of each lead through a vein (usually the subclavian vein, near the collarbone) and guides it into the appropriate chamber of the heart. The tip of the lead is then anchored to the heart wall, either by a small corkscrew-like helix that screws into the tissue, or by tiny tines that grip the tissue passively.
The other end of each lead is connected to the ICD generator, which sits in a small pocket created under the skin near the collarbone. Most ICDs have one, two, or three leads depending on the type of device and what it needs to do.
Over the weeks after implant, tissue grows around the lead tip and anchors it more firmly. This is why activity restrictions in the first few weeks are important: moving the arm on the implant side too vigorously before the leads have settled can dislodge them. Your device clinic will tell you specifically what to avoid and for how long.
You can read more about the implant process and what to expect on our ICD information pages.
Category: Implantable DevicesAre any ICD leads subject to a recall or safety alert?
ICD lead recalls and safety alerts do occasionally occur. In the UK, the Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for issuing medical device safety alerts, and manufacturers are required to notify affected patients and clinicians when a recall or field safety corrective action is issued.
If your leads are subject to a recall or safety alert, your ICD clinic should contact you directly with information about what has been found, what the risk level is, and what action if any is recommended. In many cases no immediate action is needed and increased monitoring is sufficient. In others, earlier replacement may be recommended. The decision is made on an individual basis taking into account the specific issue, your overall risk profile, and the risks of any procedure to address it.
If you have concerns about your leads and have not heard from your clinic, you can contact them directly and ask. You can also search the MHRA’s medical device alerts database at gov.uk/drug-device-alerts to see if any alerts have been issued for your device or lead model. You will find your device and lead model details on your device ID card or in your implant documentation.
Category: Implantable DevicesHow many leads will I have with my ICD?
ICDs connect to the different chambers of your heart using 1 to 3 leads. Your doctor will determine the number of leads implanted based on your individual needs.
Category: Implantable DevicesAre there guarantees that the ICD leads will not break or fail?
Leads are placed in the hostile environment of the human body, making it hard to predict longevity. Your doctor will regularly monitor your device and lead function for any signs of malfunction.
Category: Implantable DevicesWill I need new leads?
You will probably not need new leads. However, your doctor will test your existing leads before, during and after your surgery. If tests indicate that it’s time for new leads, they will be replaced along with your ICD.
Category: Implantable DevicesWhat about the leads? Are they replaced too?
Typically, the leads are reused with the new heart device. If the existing leads cannot be reused, they will stay in the body and new leads will be implanted. In certain situations, the doctor may recommend a lead be removed and replaced with a new lead. The lead removal procedure is usually performed by a doctor who specializes in lead extractions.
Category: Implantable Devices