PM juts out into armpit

Hello all,

Appreciate you all sharing your experiences. 

First PM (Medtronic) on 10/6/21 for bradycardia since birth (now 65).  Previously believed it was due to me being an athlete with usual daily range 30-59.  98 while doing 35 mins on stationery bicycle.

I am both petite & slim.  Also have very thin skin from 35 years of Prednisone therapy.   EP picked the only area with some padding which very close to the top of armpit.  I also have (2) Reverse Shoulder Replacments (upside titanium shoulder implant done because rotator cuff muscles frayed beyond use).  The only thing that raise my shoulder is my deltoid muscle.  

Incision healed well.  EP told me at week 1, OK to raise arm above shoulder. 

When I raise arm or reach across body to wash face, the PM VISIBLY slides partially so as to  jut  into my armpit like a soft daggar. Pain scale 3 out of 10.   For those who've worn a underwire bra all day, its like that, - but you can't remove it at end of day.  Nagging discomfort.

Our initial plan was to put PM sub pec, but procedure morning, the NP pointed out that spot & evidentally passed that onto the EP.

Yes, the PM has rounded edges but it is the corner that pokes out straight into armpit cartilage with movement.

1) Has anyone else experience the armpit poking &/or sliding considerably from the first week of implantation? Does it get better?

Thank you.






PM placement

by Persephone - 2021-10-18 20:12:57

Good evening, Shea - others here with relevant experience will no doubt provide their feedback, and I don't have info to contribute toward your question, but just wanted to point out that this subject has been discussed in prior posts, which can be accessed via the search function if you have not yet looked there.  Best wishes to you - it sounds very uncomfortable and I hope you can get some relief and reassurance.


by Tracey_E - 2021-10-18 20:54:32

Mine was placed under the pectoral but moved, and now it slides toward my armpit and pokes out when I raise my arm or sleep on my left side. It's annoying but does not hurt. If it still hurts after 6 months, talk to the doctor about repositioning. You are early days yet, it's going to take some time for initial swelling to go down, for scar tissue to build up around it and get numb.

Have you tried icing it for pain? I found that worked better than meds. 

Mine Pokes Out Too

by Shaun - 2021-10-20 20:41:18

Mine pokes out into the armpit too, sometimes more than others. It doesn't really bother me apart from the occasional night while I'm led on my side and it's poking out more than normal putting pressure on the pocket. When that happens I find a soft pillow under the arm helps.

Thanks for feedback

by Katy - 2021-10-21 19:13:32

Tracey, you nailed what I was thinking, should it be repositioned before too much scar tissue builds up?   And thanks to all of you for your comments.

Saw the EP at 1 week & commented that it was very close to the armpit.  Steristrips still on, very little swelling or bruising.  The next day, his office called to tell me to " fully use the arm, including raising it above my head." So now whenever I raise my arm, it slides out into the armpit.  Besides discomfort, I worry about it getting dislodged or the skin which is paper thin, getting torn.  I have the first available appointment with his NP on 10/26.

I did ice constantly the first week.  At the EP appointment, asked EP if I should continue.  He said he doesn't want anymore ice on it.

Good news is I am pacing 97% in upper chamber & .5% in lower chamber - so working well.

And oddly, my cardiologist said I didn't need one.  It was my rheumatologist who urged me to get one.

PS.  I did not get notice that people had replied.  I'm subscribed to all lists.  Is that how the forum works -  we need to keep checking for comments?

How this forum works...

by AgentX86 - 2021-10-21 19:36:27

I believe the notifications are broken (and unlikely to get fixed). so subscriptions aren't of any use.  The best stategy, IMO, is to just watch the "Recent Messages" group, unless you're looking for a specific post.  I only post there, as well.  Since notifications are broken, there really isn't any reason for the groups (if there ever was).

not yet

by Tracey_E - 2021-10-22 08:41:38

Scar tissue will help it feel better. They usually like to wait 6-12 months for it to settle down before they make a decision about repositioning. 

Leads are probably what you are thinking about. If a lead is not in a good position, it's best to move it quickly before scar tissue builds up. After the first year, it takes a laser to move the leads. Lead placement is a lot more delicate than the box. 

Thank you Agentx86 & Tracey_E

by Katy - 2021-10-22 21:11:27

Both answers very helpful. 

I did not know anyone who had a PM prior to getting mine.   Much of my pre-procedure  preparation & learning was from your site.  Both of you stood out as frequent dedicated contributors with much knowledge & experience to share.  Thank you.  I'm sure it can be tedious to answer the same inquires - often from people like me who didn't realize the forum  database was searchable for like questions -previously posted & answered.   Cheers!

Knowing anyone with a PM prior to getting one

by Persephone - 2021-10-23 21:18:42

Your comment really resonated with me, Katy.  I often feel like I could be a member of "Sgt Pepper's Lonely Hearts Club Band".  It can be a very lonely and scary situation to be in, and I'm glad to hear that you feel like you've found a good place to land here among people who share your experiences and concerns.

ask away!

by Tracey_E - 2021-10-25 16:50:01

 I will never mind answering the same thing over and over! Whatever it takes to help newbies feel better about their situation. I spent most of my life not knowing anyone else with a heart like mine, no one with a pacer, with no internet to do my homework or find others like me. I'm fortunate to have always had a team that will explain things to me and a family that's supportive but it sure would have been nice to have a place like this. It was lonely and a lot of times scary. If I can help you, I will. 

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