swelling on left arm after pacemaker operation

[Quovadisuk]

in brief , diagnosed with Afib , got three stents and had pacemaker fitted 5th June 24

Went back to the hospital on 15th June as my arm started to swell and go a purpley colour

They did blood tests . Ad a scan to rule out infection and a blood clot and both were clear

. They felt this swelling was part of the healing process after the trauma of the pacemaker surgery . It’s now the 24th June and although the purple colour is less significant the swelling is still evident . Should I keave it until my next appointment in 6 weeks or should I go back again ? Is this a common event ?

[BeKind28-]

Hello

Has the swelling gone down at all ?

If it had I might just monitor it but if it hadn't improved at all then I possibly would either make a call to my Doctor or go back and let them take another look

Let us know how you get on x

[Quovadisuk in reply to BeKind28-]

Hello again , the swelling was not so Good Friday and all I did was walking around an exhibition on Wednesday . I popped up to my community hospital 5 minutes away just for them to have a look , and they could only refer me back to the original hospital again . I did call them on Thursday and they said they would review me the following Tuesday at 10.15 am . A mile diddaponted, as I thought they may have asked me to pop over that day or Friday .? It seems they don’t seem over concerned about the swelling to leave it until next week , so is it me just just being a little over anxious ?

[BeKind28- in reply to Quovadisuk]

Hello

It could be that you might be a little over anxious as you say they do not seem to concerned

If it got any worse though I would just go to A&E but if it stays the same a week will soon go and they will take a look at it

Let us know how you get on x

[Quovadisuk in reply to BeKind28-]

Had the appointment with the cardiologist today. He feels the swelling is possibly due to a blood restriction from an artery ( not a blood clot ) where the cables run towards the heart . They are not yet sure so they are going to arrange a dye perfusion ? Test to see how the blood flows in this particular artery ( or arteries ) that could be partially restricted from after the insertion of the pacemaker or wires.

If this is found to be the case ( and this test will verify this ) there are several options on the table to consider .

If this was to go ahead, then this will require specialist knowledge and surgery . So he is to meet with his team tommorow and discuss a plan to consider the best plan of actions

He is suggesting a balloon insertion or

Bypass of the offending artery or

Removal of the pacemaker and re -install it the other side of the chest

and may be other options .

They are going to monitor it for the interim to see if my body resolves the issue itself , but not for weeks . If it hasn’t a plan will be agreed In advance and in place to follow, and will be advised what option that will be suitable for my condition nearer the time .

[BeKind28- in reply to Quovadisuk]

Hello

I am sorry to hear this I was hoping it was going to be a really simple explanation

There is a lot there to process but they seem to have options which is good to resolve this even though I will keep my fingers crossed your body might do it itself without needing any further treatment

Thank you for the update and et us know how you get on x

[Quovadisuk in reply to BeKind28-]

Hello again, I had an appointment today for a veinogram . This was undertaken by my cardiologist . The results found that the main vein feeding the arm had a restriction with the blood vessel being much enlarged before the restriction. There is blood flow to my arm but it is restricted hence the swelling, hardness and purple colour .

His opinion was that this could well be a blood clot due to bleed at the time of the pacemaker . He is to seek opinions from two other radiographers , but feels that this will/ could dissolve as time progresses , he indicated that it was like a cube of sugar as being the restriction and it was being slowly dissolved as limited blood flows past or through the cube but slowly dissolving it as time passes. He is though going to refer to others now that the issue has been identified on the X-ray . I was surprised by the size of the swollen artery, but he didn't seemed over concerned.

[BeKind28- in reply to Quovadisuk]

Hello

Well how do you feel now knowing what they think the cause is has it made you feel better in anyway ?

It is a good thing that even though he is going to get some more opinions again another good thing he feels he knows what the cause is and they will or should monitor it

Another positive I know these things are a worry to us but he no doubt has seen it before and if he is not worried that is a good sign

They will rectify this if it does not do it by itself so be assured of that

Thank you for letting me know how you have got on and any updates I hope you will let us know x

[Quovadisuk in reply to BeKind28-]

Thank you for your for your feedback. I feel 50/50 More happy that the issue has been identified , but also conscious that blood clots are not the b st thing to have in blood vessels . The safety net for me is that he is now aware, and also if things got worse they now know what they are looking for . Hopefully things will improve on its own without further procedures , If there are any issues I can jump to A&E and this would show on my notes so this is a comfort knowing this option is there .

I will of course update you as I progress with the cardiologist . Thank you again for replying .

[BeKind28- in reply to Quovadisuk]

Hello

Yes I can imagine that is how you would feel I would no doubt feel the same but take all those positives and I suspect you are on blood thinners maybe ? if so they hopefully will help to keep things flowing and break it down

As you say you have got the answers now so you know what you are dealing with and they always solve these issues so try and stay positive and will look out for any updates x

[Quovadisuk in reply to BeKind28-]

hello again

I had another cardiology appointment today as It was to be cancelled but due to swelling of the chest and arm on Sunday they maintained the appointment .

The issue is that I am now taking painkillers at night and on Sunday had a large swelling under the pacemaker that made it show its shape under the chest skin and the arm was hard with shoulder pain .

He is to have another team meeting tommorow concerning my case but confirms it now looks like. A blood clot that is causing the problem

I did go with a 10 l question list to ensure aI didn’t miss anything and one of my suggestions was to increase dosage or change the blood thinner tablets I am on to see if this clot can be dissolved quickly . He has taken this onboard and suggests this would have been one of the solutions the team may come up with . If this doesn’t help then the alternative is to have the blockage removed as a last resort . I asked a time scale for this as it cannot go on indefinitely , and he suggested three months if they looked at a med change first . Should the swelling increase in my chest or arm I should attend A&E . Otherwise carry on as normal but don’t do anything to strenuous like using impact tools etc .

They did a check up of my pacemaker and that is working fine . I go back again to discuss the plan for the arm and swelling on the 8th August

[BeKind28- in reply to Quovadisuk]

Hello

So pleased they kept your appointment and good news that your pacemaker is working well so there are two positives

Good for you going with your list I always do the same and you did even better by having thought it through and put some suggestions to them

Sorry that it seems a blood clot has formed but usually they can dissolve these so hopefully the team will decide as that would be the easiest way to do that they always have to tell us the worst scenario to cover themselves but fingers crossed they will feel that trying the blood thinners route will solve it and I know 8th August till you speak again with them might seem a while away but it is just a couple of weeks so it will soon be here and hopefully then they can start the plan and get this sorted

I hope the appointment has made you feel a bot better even though I know you would rather have it sorted but it will be and you know to take it easy till they do

Keep us updated how things go and thank you for letting us know how today went x

[Quovadisuk in reply to BeKind28-]

hello again saw the cardiologist yesterday and he confirmed the blood clot in the arm . Consensus of opinion at his team meeting was to leave it alone and try to resolve it with the Apixaban blood thinners . He has however arranged another veinigram to check against the first image to see if has reduced or enlarged . I await that with antcipation that it it has reduced in size or at the very least remained the same . I will update once I know regards

Ps Is this a common thing ?

[BeKind28- in reply to Quovadisuk]

Hello

Hopefully it will not have got worse and with the blood thinners it is known they can disperse them so try and stay positive and they are keeping a close eye on you which is good

Not sure how common it is but I have heard of it happening before so you are not the first and doubtful the last either

Thank you for letting me know and if you would I would like to know how vienagram goes so I hope you will keep letting us know how you get on x

[Quovadisuk in reply to BeKind28-]

will do kind regards

[BeKind28- in reply to Quovadisuk]

x

[Quovadisuk in reply to BeKind28-]

Had another veinogram recently and it showed I still had a blood flow restriction but my body is now growing new veins to circumvent the area so no further actions at this stage . I do note that my pacemaker does stick out more and it itches a4ound the incision area . It’s not red or infected etc , but wondered why I would be feeling this at this late stage of events I have an appointment to check the pacemaker at the end of the month so will raise this issue with them kind regards

[BeKind28- in reply to Quovadisuk]

Hello

This sounds more positive than it could have been I hope once you have had your appointment and get your questions answered it will give you peace of mind

Hope everything goes well and if you can you will let us know

Thank you for your update x

[Gerry15]

Give your pacemaker team a call. They should be able to see you quickly and assess your pacemaker and if it’s healing correctly. I also had swelling, as well as purple bruising that covered the whole area around the pacemaker and down to the elbow on my left arm. The consultant wasn’t worried about the bruising but did say that the swelling was caused by a big haematoma which had to be treated. It took six weeks before everything settled down. Good luck.