CRT

I'm deciding between having the device under the skin (I'm thin) or behind the muscle.  How noticeable is the device in both cases?  I'm told behind the muscle is more painful, more bleeding, healing time, but it woudn't show as much as below the skin


5 Comments

CRT

by AgentX86 - 2021-06-24 16:57:02

CRTs are larger than a more normal pacemaker. A CRT-D, even more so.  I have a sub-Q CRT-P.  Even though I'm not thin (much thinNER), 5' 10" 200lbs, my PM and leads are clearly visible. I'm a 68yo guy so it doesn't bother me one bit but I can understand the issue. I'd rather have had te relatively pain and trouble-free surgery than the cosmetic improvement.

That said, placement under the muscle protects it better than sub-Q. I could never stand any weight on my shoulders, so that isn't my problem. If I backpacked, I'm sure I'd come to a different conclusion.

 

May depend on your surgeon's placement plan

by Persephone - 2021-06-24 21:30:10

I would ask your medical team where they plan to place the device, if you would choose subcutaneous and not necessarily sub-pec.  My subcutaneous PM protrudes and I am normal-sized.  If the surgeon would have told me any options beforehand, I may have asked for different placement, maybe not sub-pec but at least not so high and kind of centrally located as mine was placed.  This is just an appearance thing and basically only affects my clothing choices, and is not related to functionality.  Since it is a more central location, I don't have pbms wearing a light backpack or playing a rather heavy guitar wearing a shoulder strap on the PM side, so maybe it's a wash either way.  I hope that whichever location you choose, you will feel well with your device and are able to do the things you want to do.

CRT

by Julros - 2021-06-24 23:56:25

I have a CRT-P placed subcutaneously. At the time it was implanted, I was overweight, and I doubt the EP gave it much thought. Plus, I bled quite a bit during the procedure due to Eliquis, so perhaps that was a consideration. I have since lost 50 pounds and the shape of the device is clearly visible, plus the corner where the wires connect pokes out. 

If your worried at all go under the muscle!

by asully - 2021-06-26 03:05:44

The crt-p devices are larger than many realize, I was shocked after my upgrade from a regular dual chamber pacemaker!  I had been told it was only slightly larger (I should have asked to see the devices side by side)! Mine was abdominal and stuck out a ton.  I have since been upgraded to a crt-d (largest of them all), and it was placed on my chest under the muscle.  Now that the swelling has subsided I can say I am very glad I went through the extra bit of pain and recovery as the device is still clearly visable and prominent.  I can't imagine what it would have been like if I hadn't had it under the muscle.  Please take into consideration that I am a very thin, and boney female.  I have very little natural padding so this may or may not be as much as an issue in you case.  At one point, before it became an urgent matter we had talked about placing it on the side of my chest under my armpit as an option and having a plastic surgeon do some magic to cushion and hide it.  If yours is not an urgent surgery you may have the luxury to discuss more options.

not in France

by Tulp - 2021-06-26 23:28:42

Just wanted to point out that in my hospital in Toulouse - France, they don't place à CRT-D under the muscle anymore.

I tried with my cardiologist, but the answers was : nope no cant do. They told  me that they had too many problems.

I am a tall and large women. I can certainly see it, ans feel it, but its fine with me.

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