John Williams, an active pacemaker recipient, says he was dismayed to learn that one of his pacemaker leads may be broken and that he may require immediate surgery to have it replaced. Given his relatively young age and good physical condition, John didn't want to make any decisions without first obtaining a second opinion. So, at the advice of a good friend, he reached out to Cleveland Clinic from his home in New Hampshire to seek some expert advice. Cleveland Clinic has been ranked number one in the United States for cardiology and heart surgery since 1995 by U.S. News & World Report.
John received his pacemaker at the age of 40 for intractable neurocardiogenic syncope. He was 59 last year when his local cardiologist let him know that a recent evaluation indicated that one of his leads may be fractured, and immediate surgery was recommended. "I have a friend who has also had a pacemaker for more than 19 years," says John. "He had a very positive experience with Cleveland Clinic and recommended that I contact the office of Dr. Bruce Wilkoff for advice." Dr. Wilkoff is a renowned cardiologist at Cleveland Clinic who specializes in pacemaker implantation, repair and extraction. "When I contacted Dr. Wilkoff's office, I was very pleased that his staff was very receptive to the situation and interested in being helpful. They referred me to the MyConsult Online Medical Second Opinion program in order to get the formal second opinion process underway."
Cleveland Clinic's MyConsult® Online Medical Second Opinion program is a sophisticated, Web-based extension of Cleveland Clinic's 90-plus-year role as one of America's most respected referral institutions. The secure, online program provides medical second opinions from Cleveland Clinic specialists for more than 1,200 life-threatening and life-changing diagnoses. So John gathered all of his medical records and sent them to Cleveland Clinic for triage by the MyConsult nursing team. "The main questions I wanted to have answered were if I needed immediate surgery and if so, should I consider removal of the pacemaker lead should it turn out to be fractured, in contrast to just adding another," says John. "I'm very physically active and plan to stay that way for at least 20 more years. So if more wires are placed in veins that return to my heart, could that restrict my blood flow and limit my ability to be active going forward? I wanted Dr. Wilkoff's medical opinion, but I also hoped he would take into consideration my age and lifestyle."
Dr. Wilkoff reviewed John's medical information and provided a detailed response in a comprehensive report. "Dr. Wilkoff's response was truly profound," says John. "He recommended that because I'm a healthy, active individual and because my current pacemaker has at least two years of battery life remaining, there didn't seem to be any compelling reason to go into surgery immediately. Instead, I could wait until my battery needs to be replaced to evaluate if my lead is truly fractured. If it is, he'd recommend lead extraction once the new lead has been inserted. It was a huge relief. Not only that I could wait for surgery but also that Dr. Wilkoff's approach was to do what's best for my specific circumstances."
If fact, John was so grateful he wrote a letter to the MyConsult team and Dr. Wilkoff expressing his appreciation. The following is an excerpt:
I wish to extend my sincere gratitude to Dr. Bruce Wilkoff for his well-considered report on the topic to consider removal of pace maker leads. The detailed review comments have had a most profound, positive effect on me and my partner. It is hard to express the great level of relief and encouragement that this alternate opinion has given. The assessment, which provided a differing opinion and possible explanation for a determination of a faulty lead, has opened the doors to consider review of the diagnosis and an alternate direction of treatment. I most appreciate the honest and heartfelt opinions which seem to value the life style considerations which are very important to this patient.
John says he would absolutely recommend the MyConsult Online Medical Second Opinion program to those seeking a second opinion. "I'm extremely grateful that Cleveland Clinic offers a service like MyConsult to make experts like Dr. Wilkoff available to any patient, anytime, from wherever they may be," says John. "The time, care and consideration that Dr. Wilkoff gave me brought tears of joy to me and my partner. This experience has made a huge difference in my life."