Subdermal vs Subpectoral

You have to lead this conversation

by crustyg - 2020-11-26 13:21:04

Unless you raise this you'll get your PM placed where it's most commonly implanted.

Your EP doc may well push back on any other placement, and I'm told that sub-pectoral is *much* more painful for the first few weeks.  You need to have some compelling arguments/logic/reason why it shouldn't be placed in the usual position.  Doesn't mean that you can't get it implanted to a different pocket location, but it's not a simple matter of choosing two equally good locations - it impacts both you and your EP doc.

Search some of the other historical posts about this for other people's experience.

HTH.

Device position

by Gemita - 2020-11-26 14:50:19

Sandoval, I agree with crustyg’s comments.  

I would learn as much as you can about your choices and then there is no harm asking about what options are available to you.  Looking through Pacemaker Club old posts, a deeper placement is cosmetically more acceptable and longer term potentially more comfortable, once you get over the initial hurdle of longer recovery and more discomfort from a deeper placement.  Remember in the future it may not be so straightforward to replace the device though and I am not sure whether you can go from subpectoral to subdermal, so there are questions to ask.

I wasn’t given a choice where my device would be placed, but I did have a pre op in my London hospital because my EP wanted to implant under a general anaesthetic.  During pre op I was able to chat freely with a doctor about what would be happening during implant and I had all the necessary checks at the same time:  bloods, X-ray.  

Because of your potential CRT-D pacemaker however, I do feel that you will have the opportunity to be called in prior to your implant.  As soon as you get your date through I would ask about a pre-op, so that you can ask lots of questions this time.  It sounds as though you really need to do this.

Personally if I may say so Sandoval, I feel that it is more important to focus on getting the right device before you worry about subdermal/subpectoral positioning.  The correct device will make such a difference to your quality of life.  Maybe the device choice (CRT-P or CRT-D) will determine in any event where the device can be placed?  Only my opinion Sandoval, but I hope this helps.

Sun pec

by sandoval - 2020-11-28 22:17:59

Ar_vin - I don't do scrambling or climbing but I carry a golf bag around with the strap over my left shoulder for a few hours a few times a week. Of course I realise I can't play for several weeks anyway so not sure if it would make any difference after the site has healed.  I'll ask and see what response I get.