Pacemaker migrated...alot

Good morning. I had my pacemaker placed on May 11. Since then I have had numerous issues with the settings that are still not resolved (I am one of the lucky ones who feels this thing working/not working properly), but now have a new issue. My PM has moved considerably. It has gone from under my clavicle about 4 inches lower into my breast. I was feeling breast discomfort and went in for my annual mammo and there it was, right in the middle of my boob. 

I have gotten push back about every issue including this one. Being told that what is happening isnt, but now I have x-ray proof. Now he says he doesnt want to move it. Whaaaa??! This thing has moved 4 inches in three months..so I have to wait until it comes out the bottom??? 

Am I crazy or does this happen and people just let the thing move around where ever and deal with it? I cant beleive that. I am just so frustrated. Please advise... Thanks. 


4 Comments

Pacemaker migration

by Selwyn - 2021-08-19 19:46:48

MIgration of a pacemaker should not happen, but it does!  Twiddler's Sydrome, where fiddling with the implant can cause this. A failure of the fixing suture (stitch) will also cause this, especially if the tissues are mobile  with a fatty layer, as can infections of the implant 'pocket'.

"It if ain't broke, don't fix it" is reasonable advice. ie. if your PM is working fine, not causing you symptoms, then why would you want to fix it?  It can of course be repositioned if it was causing symptoms. This would be at some cost to you, from discomfort due to the further surgery. I am sure they will keep a close eye on the PM position and intervene as necessary. 

I lost of people would envy your position in having a PM box that is not visible! 

Migration.

by Pharnowa - 2021-08-19 21:26:58

I can appreciate your frustration and concern; no one wants a PM on/in their breast. It sounds uncomfortable and I wouldn't like potential problems with foreign objects in breast tisdue. I wonder how gentlemen would feel about their PM squeezing into their scrotum.

Mine migrated partially into my armpit and I have adjusted to it. Into the breast is different, IMO.

I wonder if your doctor is discouraging moving it because if payment. I know insurance will not pay if it's for cosmetic reasons. It should be covered if it migrated through no one's fault.

If you are not satisfied with thus position, bring it up again. A second opinion may be needed. 

Best wishes!

shifting

by Tracey_E - 2021-08-20 10:39:08

They often shift, mine has. Sometimes they aren't stitched. Sometimes they are stitched but the stitch comes loose. As long as the leads are not compromised, as long as it's not painful, it's better to leave it than have another surgery. Every surgery carries an infection risk. 

I have to disagree with Parnowa, I had my first 4 planted submammary. On purpose, done by a plastic surgeon. It was very comfortable, even through pregnancy and nursing, it did not hurt during mammos. I was mad (that's putting it mildly) when it was moved on my last replacement. The surgeon didn't like that it was so deep so he moved it to subpectoral, after I specifically said I wanted it to stay where it was when we discussed it pre-op. It shifted from the subpectoral position and now it sticks out a bit and shifts when I raise my arms and I don't like it. I discussed moving it with my new doctor, he offered to move it deeper. I considered it but ultimately decided to leave it alone for now. It's annoying but not painful, my leads are not in any danger, so it's not worth another surgery. 

Get a second opinion if it will make you feel better about it, but to me it sounds like the new position is better than where they put it. It will settle in and scar tissue will grow around it. It will not continue to move indefinitely. 

Migration

by Pharnowa - 2021-08-20 12:32:43

In response to Tracy_E,  I interpreted that TIMEX described her PM moved "into' her breast, which differs from settling, or being positioned,  "under," the breast. She stated she had discomfort which prompted getting a mammogram. There are articles inline of PMs moving into the breast and conclusions varied,  including that it shouldn't be left that way and some that concluded it could be.  It depended on where it stopped. We don't know her  circumstances and she clearly is concerned. 

If it were me, before I'd accept an EP dismissing my concern, I'd consult a breast specialist to weigh potential risk to the breast before I decided to  leave it.  Also, the amount of discomfort she is having is relevant.  Maybe that will calm, but maybe it won't. 

 

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At age 20, I will be getting a pacemaker in few weeks along with an SA node ablation. This opportunity may change a five year prognosis into a normal life span! I look forward to being a little old lady with a wicked cane!