I spoke via Zoom with my cardiologist this past Monday. One thing he expressed concern over, and yes I've had some problems with this, is how high up my device is. In truth, I can feel it hit my left collar bone when I am at work. I have had my device about two months now and am getting used to it being part of my life. However, when I move my left arm, there is some discomfort. My cardiologist suggested that perhaps we should consider having it moved down and little more to my left. Has anyone else had to have their device relocated? I don't necessarily want to go back into surgery, but there are days where it is not only uncomfortable but even painful. Any suggestions or opinions would be appreciated.


Have it moved

by crustyg - 2020-08-29 03:09:14

Pocket placement for the PM is as important as choice of lead length (they come in various fixed lengths), type of anaesthesia etc.

You definitely need to have your PM moved if it's hitting your collar bone - clavicle - and the sooner, the better.  Unfortunately it's not entirely trivial - I had my PM and leads fitted under local and I can attest that having the pocket created was pretty much the most painful part (even including the fact that I felt all the skin closure stitches and the big anchor stitch that holds the PM down to the back of the pocket - the local had worn off).

So for you, you will almost certainly need to have your pocket adjusted/resized.  But it has to be done.

Your EP doc will know if your leads are long enough - a plain CXR will show if there's a little loop of spare lead behind the PM, in which case moving the box down your chest is feasible.  Make *sure* that you discuss this with your EP doc and he shows you the picture.  It will be a disaster if your PM is moved down and then pulls on your leads and breaks them or pulls them out of the heart.

I'm afraid I would have my doubts about my choice of EP doc in your shoes.  This is fundamental stuff that should not need to be revised - but I urge you to get it done properly before too much scar tissue forms around the PM itself (which can be a real pain to separate from the box).

Good luck.


second crusty's advice

by Tracey_E - 2020-08-29 10:29:26

It may settle a little more but it sounds pretty high. Doing it sooner than later is easiest. 

I have a similar placement issue

by Persephone - 2020-08-31 19:32:47

Hi AE7XQ - my device also rests partially on my collar bone.  It has settled pretty well over the 2.5 years since it was installed, but the settling took a long time.  I have minor ongoing discomfort if I try to do something more strenous than usual (pushups after not doing them for months, for example), but basically inconveniences rather than problems.  My cardiologist was not concerned about the placement when I pointed it out.  Just sharing my experience - best wishes to you.

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