ICD Lead fracture or leak?

[Mom2four85]

I had a Boston Scientific Teligen 100 w/Guidant leads implanted on August 28, 2009.  Almost 2 years later my  thresh holds remain high at almost 1100 and I was told they want to repair or remove them because my interrogations keep showing loss of capture, noise and tons of events that look like artifacts (254 just since May 19th).  

My last cardiologist said I don't need the leads out because I'm not pacemaker dependent, but I saw a new EP last Friday who did 45 min of extensive testing on my ICD.  He said I should have never left the hospital with the leads the way they were or at the very least had them repaired within a few weeks time.

I still have my original problems that I had before implant, pvc's & nsvt runs daily, pre-syncope, dizziness, shortness of breath but it did alleviate complete syncopal episodes.

I was told symptoms from lead fracture or a leak would be acute, sharp pain in the upper middle abdomen, which I started getting in September 2010 with no insurance I couldn't get it checked.

Does this sound like a lead leaking or fracture? What exactly happens with leaking - does it leak in your body? Could this cause other problems if it leaks for a certain time? Are there symptoms with leaking or fracture as my dr in 2010 told me?

Thanks in advance any help or info is appreciated.

[Mom2four85]

Thank you for the response.  Just a follow up with the answers.

I had an ablation in August 2009 for roughly 50,000 multi focal pvc's; my EP induced me into polymorphic VT 3 times which he thought was caused by ARVD.

I had a cardiac MRI that was inconclusive and my cath showed I had a moderately elevated LVEDP and non ischemic cardiomyopathy, other than that I had just minor things wrong.   That with my lifelong history of syncope and VT they felt it a necessary preventative measure to implant a pacemaker/icd.

I was also diagnosed with ANS (autonomic nervous system) dysfunction and have classic symptoms of neurocardiogenic syncope with cardioinhibitory and vasodepressor responses; when I faint I have no palpable pulse and my bp drops profoundly during a tilt table test.

After implant, they tested the device and found the leads were high; around 810 and kept me an extra day to retest.  The Boston Sci tech consulted with one of the dr's and said the lead numbers were ok and discharged me.

Since implant, the leads have been high and rising and are now at the 1100 mark; which I was told by my cardiologist who monitored my device at that time, they would have to be fixed around 1100.

I believe they referred to it as an insulation "leak" or lead fracture.

[CCF HeartMD6]

I am unclear what "leaking" actually means. However, regarding a possible lead fracture -- I would suggest that you speak with the original electrophysiologist who implanted the device. It would be important to know why your ICD was implanted in the first place (primary prevention vs secondary prevention). There is inherent pacemaker function in all ICD's but it is possible that you don't require this at all.  However, the ICD portion is what would be concerning -- especially if you have sustained a cardiac arrest or a ventricular arrhyhtmia already in the past. Lead extraction is not a benign procedure so it is also important to know whether the high thresholds noted on your last interrogation is an acute event, or something that has been progressing (although 2-years seems a bit early).

[Mom2four85]

does anyone know? I guess on the dr's black list lol

lead failure, leak, oversensing etc? are there symptoms? is it dangerous to leave a leak or broken lead?