Placement of pacemaker

I learned that a patient opted to have the pacemaker implanted in a deeper muscle layer. What are the issues involved in this decision?


A brief list

by crustyg - 2021-02-01 11:18:46

1  Willingness of EP-doc to defer to your wishes

2  More pain and slower healing from the implant site

3  Considerably longer for implantation - sub-dermal pocket creation is pretty quick

4  Better cosmetic result for thin folk with PM beneath Pec Major, or for the smaller female folk less obvious on the bust line.

5  Probably not suitable for a local-only implantation.

Search for this on previous threads.  It's not always possible, *especially* for 2nd and subsequent PMs (not an issue for you).  And some EP-docs just refuse to listen.  Avoid them.  There are a *few* EP-docs who farm the actual implantation out to other surgeons (it used to happen a lot) and it's very easy for this type of critical request to be lost if this happens.

Sub-pectoral implant

by ar_vin - 2021-02-01 13:17:27

It's between your EP and you (assuming you have a competent and experienced EP).

I discussed getting a sub-pec implant with my EP in advance of my procedure and he readily agreed based on my lifestyle choices (before and after implant). I hike and backpack and carry a pack; pack straps are more likely to cause issues with a sub-dermal implant.

This is my first and only implant and I experienced NO issues either with the procedure or recovery. I was "awake" during the procedure with mild sedation and didn't feel much pain. Recovery was unremarkabale and I didn't take any painkillers during the overnight hospital stay or after returning home. YMMV. I did ice the site for 2-3 days including the night of the implant at the hospital.

I did have significant soreness at the site overnight and for the next day or two. I did start walking 3-4 miles two days after the implant while being careful with my arm swinging too much. 

I do seem to have a rather high pain tolerance.





I just had this done!

by TraJac71 - 2021-02-03 20:39:09

OMG ~ I just had a pocket revision where they went to my lower chest wall under the pectoralis to bury the device. For me, it was 100% the right thing to do! And I only got my original PM 6 months ago!!

I didn't care about the asthetics of it, but I was having SO much constant pain in my left neck and left chest area. I'm talking level 9 pain all day. EVery day. It was unbearable and I was seriouslygetting depressed at the pain I was in. I eventually was sent to a thoracic surgeon who said we could try burying it deeper and hopefully that would work. It was a crapshoot, none of were sure it was going to work, but I had to do something.

It was seriously painful. He warned me that it would be and I'm a month out from that and still have soreness, BUT, it was the best decision I could have made.

I don't know the criteria for sub pec for other people, but I wouldn't hesitate having it done that way.

You know you're wired when...

You have a high-tech ticker.

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But I think it will make me feel a lot better. My stamina to walk is already better, even right after surgery. They had me walk all around the floor before they would release me. I did so without being exhausted and winded the way I had been.