Third lead for ICD

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Q;

My husband is 70 and in great shape.  He has and EF of 25% and had a two lead ICD 3years ago at Cleveland Clinic.  Last year they tried to add a lead but were not able to because of scar tissue.  The other option was surgery through the chest.  His doctor has said that the risks would not justify the benefits of the third lead.  He shows no other physical symptoms of heart failure from all the questions they always ask him.  He does get more tired now than a few years ago.  He exercises regularly… walks and light weight workouts.  He has no fluid retention.. breathing problems, etc.  I have read that the biventricular ICD does prolong life.  Do you agree that surgery to add the third lead is too risky? Thanks for considering my question.

A:

Your doctor is correct, the risk is not worth it. Most benefits come from the original implant (although I wonder why the 3rd lead wasn’t placed then). Has the ICD ever shocked him? If not, that reinforces my opinion he doesn’t need an operation. Patients with poor heart function can live a long life with the kind of treatment he gets.
If you’d like to know more, read this:
http://www.cardiac-risk-assessment.com/heart-information/heart-failure
Hope this helps,
Dr T
http://www.cardiac-risk-assessment.com/

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