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Dr. Andrew Rynne

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Does a pacemaker implantation cause blood clots in the retina, causing vision problems?

Answered by
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Dr. Sagar Makode

Cardiologist

Practicing since :2013

Answered : 1754 Questions

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Posted on Tue, 11 Sep 2018 in Hypertension and Heart Disease
Question: Patient History -

In 2007, Patient was falling unconscious while walking and it was diagnosed that BP was suddenly falling very low and Doctor had implanted combo device pacemaker of St. Jute after all the diagnosis and test.
After 5 years, in 2012, a device of same brand and specification was again implanted because the battery of former packemaker was exhausted.
Last month, XXXXXXX 2018, Patient was having problem in viewing things and it was diagnosed that blood clot has come across retina that's affecting the visibility and Patient was advised to see cardiologist.
We are having multiple opinion from different cardiologist. Some of the cardiologist doesn't feel the need of implanting new pacemaker but some of advising for implanting pacemaker.

We need your advise in this case.I have attached all the reports.
Appreciate your help!
doctor
Answered by Dr. Sagar Makode 41 minutes later
Brief Answer:
Reports are fine.

Detailed Answer:
Hello,

Now, regarding your debt of implanting a new device, as he already has the best possible device, I don't think he needs another one. Although, I will see his reports. But just for the clot migration, we don't change any device. Its possible, battery might have to be changed since it's 5 years since battery change. During battery change, they change the whole device rather than a battery, it's usual pattern.

Combo device has a function of both CRT, P and ICD so it's served all the purposes for which devices are put. It takes care of pacemaker, improving heart function, giving shocks if needed. So there is nothing left. So please get back with reports and also let me know, what exactly you are told or given a reason to change the device so that I can clarify it.

I have gone through the reports. Reports are fine, however in the ECG interval is wide, and we want it to be as narrow as possible.

Now, were you advised to change the device or change the lead of the device? Because if the course is wide and other investigations like device interrogation and chest X-ray showing lead misplacement or inability to achieve parameters on interrogation, then one may advise for lead re-position or lead change. Otherwise, there is nothing else which I found in the investigation or history to suggest device change.

Regards,
Dr. Sagar Makode,
Cardiologist
Above answer was peer-reviewed by : Dr. Kampana
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