Very bruised left nipple

Two years ago I had a basic pm after AV node ablation, but I soon developed permanent Atrial flutter and  my LV function became moderately impaired. I also had two VT episodes a year apart. The latter in January, conveniently as I was walking up the stairs to the Cardio dept.   Cardio advised an upgrade to a CRT-D.  Had this done two weeks ago.  Have had a bumpy recovery so far and feeling pretty exhausted.    When I was allowed to shower, I noticed my left nipple was very bruised.  I know they had to enlarge the pocket and was aware of the whole procedure!!  Is this the reason for the bruising?



by AgentX86 - 2021-04-20 17:48:38

Where was your pacemaker implanted? Under the skin, under the breast tissue, or under the pectoral muscle? Normally sub-q implants would be well above and more toward the shoulder but it is  probably caused by the combination of your surgery and Rheumatologist anticoagulants that you're undoubtedly taking.

I had both AV ablation and PM implant done at the same time with only a local anesthetic, so was quite aware of what was going on.  Making the pocket wasn't fun and games but the rest wasn't any problem. I didn't have much bruising but it's easily seen how this could happen. Hematomas aren't unusual at all and spreading in any direction isn't unimaginable.

Separate question. when you developed flutter, do you know what mode your pacemaker was set to? I'd guess VVIR to wall off the flutter. I'm surprised they didn't give you a CRT pacemaker at that time.

I had an AV ablation for permanent flutter (after a maze gone wrong) three years ago. They went for a CRT-P right away to avoid PIC and the need to change later. I've never had a VT episode so no need for a CRT-D.

Just wondering.


by Theresa52 - 2021-04-21 10:02:48

Hi - I had the AV node ablation in March '19.  In June 19  I had the VT episode out of the blue while I was writing an email. Never had any VT before the AV noe ablation.  My heartrate was set to 70, but after the VT it was raised to 80 to try and suppress the many ectopics I was getting.  My meds were changed from Sotalol to Bisop.  but I could not tolerate it, so went back to Sot.

In August 19 a device check revealed I had gone into permanent flutter.  Then an ECHO showed EF reduced since the AV node ablation from 55% - 46%.  Nothing was done until I almost passed out in Jan this year.  Another ECHO showed EJ was now 41% and heart out of sync.

So now, I have the CRT - D.  I have checked with the hospital today about the bruising and they have said it is probably because of Warfarin, but if it gets worse I have to ring them.


by Aberdeen - 2021-04-21 10:48:25

I had a dual chamber pacemaker implanted in January 20 which had to be changed to a CRT pacemaker in May ‘20.I had extensive bruising on my left breast and side (about the size of my hand) . Possibly caused by placing of the third lead. Eventually it disappeared.


by Theresa52 - 2021-04-21 12:42:51

Hi Aberdeen - it is a year on for you now.  How are you feeling?  Did the new device resolve your issues?

Almost a year later

by Aberdeen - 2021-04-21 14:35:02

Thank you for asking! I do feel well, I had an echocardiogram in October which showed that my ejection fraction had increased dramatically. So far so good!

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