PM Location & Having it Re-Located

I am new to the group and 6 wks to the day of having my Bost Scientific PM implanted.  I am a nationally-ranked masters swimmer and have been out of the water this entire time + a week or so pre-implant as I was wearing a heart monitor and then had one implanted to better monitor my rhythm.

I feel the placement of the PM is too close to my left shoulder and am concerned that it will interfere with the free movement of my arm in the various swimming strokes.

Not necessarily specific to swimming, but has anyone had an issue with the PM being located too close to their shoulder/armpit and having to have it moved (in this case to the right)?  If so, do they have to replace the electrodes as well, or is there slack in them to accommodate a degree of re-location of the PM?

Any experiences will be welcomed.

Thanks - RogerK


8 Comments

Experience?

by AgentX86 - 2022-12-22 16:42:30

Personally, no.  There is a recent thread here about this.

Yes, there would be plenty of slack in the leads to do this.  The leads have to account for any motion you ever might have so there is a buch left.

IMO, this would be elective surgery so you'd likely have to go through your insurance company to get it paid.  You might have a case.

Please fill out your bio.  The information will help others answer your questions. I'm not sure what country you live in so my answer just assumes the US.  The answer would be quite different if you lived in Canada or the UK.

relocating

by Tracey_E - 2022-12-22 16:43:56

There should be slack, yes. They often coil the extra and tuck it behind the box. They should not need to mess with the leads in order to relocate the box.

Depending on your build and your placement, it is possible your level of activity can put extra stress on the leads and cause them to wear out prematurely. When did they say you could swim again? The only way to know if it's going to be in the way is to swim and see. You may find that it moves with you and does not get in the way. 

How it is now is not necessarily how it will be when you are fully healed. It will continue to settle over the coming months, and scar tissue will grow around it. They generally like to wait 6-12 months to consider repositioning. 

Mine shifted later and it pokes out. We discussed repositioning it deeper where it's supposed to be but I opted not to. It's annoying but not painful so I'll deal until my next replacement. 

PM location for swimming

by ourswimmer - 2022-12-22 17:47:57

Give it several months at least before you draw a conclusion.

I also am a serious swimmer and I got my device at the end of March 2022. My pectoral muscle stayed a bit tender for many months and the scar itself is still very sensitive although it has improved a lot since summer. My suit strap goes right across it (which I discussed with the surgeon before surgery, pointing out my swim tan, but he said sorry, it has to go there). I put Body Glide on the scar before I swim.

So you may feel some movement restrictions from those issues for a while, but they will resolve. The device itself is so small that I doubt it will interfere in the long term with arm mobility. I was advised not to swim fly any more, however, because it involves such extreme thoracic extension. I like fly but I can live with that limitation because I really like having a little robot helper to get my HR up.

PM Location & Having it Re-Located

by RogerK - 2022-12-22 20:23:06

Thanks for the responses.  I appreciate it......

Agent86....I am in NY.  Not sure how med insurance will view it and will cross that bridge if I have to.  I appreciate the heads-up re that.

Tracy_E......thanks for the input.  Glad to hear that there is slack as in theory a new surgery and the healing time would probably be less.  They have been keeping me out of the water for fear that when I get back in I would swim too hard and 'rip-out' the electrodes.  I am pretty sure my cardiologist told the EP to keep handcuffs on me as long as he could.

 

Ourswimmer.....I don't have any pectoral discomfort and I am a male so I don't have to worry about bathing suit straps though I did have to get a cushion for the seatbelt in my car.  I swim free and fly sprints.  I didn't plan to swim fly until I was back in the H20 for a month.  I have been in the gym with my trainer doing leg and AB exercises.  I am also using an exercise bike and an eliptical.  My scar is still sore, and the space between the edge of the PM and my shoulder is sore.  I am hoping that the swimming willl not be impeded, but I am concerned by the fact that when I type on the computer, just having my hands/arms angled inward towards the centerline of my body creates pressure and discomfort in the area between the device and my shoulder.  My fingers are crossed that I will be fine when I am engaged in the actual swimming motion.  I want to swim in a local meet in February, and then am targeting the Summer Nationals in early August.

PM location swimming

by skigrl3 - 2022-12-22 20:25:32

Agree with those that say to wait and evaluate first. I am a skier and mine is up near clavicle and I am concerned about arm movement during poling when skiing (plus injury and damage to pm of in case of falling while skiing but that's another story). I have skied 1x so far this season and my pm did not appear to be bothered, so still evaluating. That is my advice to be conservative and evaluate before making a move to relocate your pm. As others stated, it would be elective procedure at this point as well. Good luck to you.

scar tissue

by new to pace.... - 2022-12-22 20:43:05

Find yourself a good acpuncturist to help with the healing of the scar tissue.  Worked for me.  Remember your body has to adjust.  give yourself time to heal.  One day you will be again swimming and forget you have a pacemaker.

new to pace

returning to swimming

by ourswimmer - 2022-12-22 22:26:10

Have you specifically discussed swimming fly, at sprint race pace, with your EP or surgeon? Shown them videos, maybe? Explained that what you do when you swim, while not as fast, is still more like what Michael Phelps does (did) than what most people and doctors think of when they think of older "lap" swimmers?

If you have, and that person has given you the green light, don't let me stop you. But I am a little surprised. You also might have a frank conversation about starting from the blocks. I am a distance freestyler and a backstroker, so powerful forward starts are not as critical for me as they are for someone who sprints face down. (OTOH, back starts from the grab bar on the block involve similar thoracic extenson to fly, and I am probably going to start by just dropping in from now on.)

Anyway, my cardiology team told me not to swim for three months post-implant. I was OK to immerse myself sooner, so I went to workout and kicked. I also went on a trip that involved some snorkeling. Now I just stick to freestyle and backstroke but I feel good in the pool and safe again in open water. Also hoping to be raceworthy in 2023.

sports cardiologists

by Tracey_E - 2022-12-23 08:25:09

You may want to consider finding a sport cardiologist, even if it  means travel. If not that, then at least find one who is very active and has other younger active patients. I see an adult congenital ep, before finding him I saw a cardiologist who is himself a runner. Doctors like these will go out of their way to support our ability to stay active and you'll find the attitude is very different from a sedentary doctor with mostly sedentary octogenarian patients. It sounds like your current doctor is not a good fit. Could be a perfectly wonderful doctor, but not necessarily the right doctor for you. 

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