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The Subpectoral Pacemaker Implant:
Author(s) -
KISTLER PETER M.,
EIZENBERG NORMAN,
FYNN SIMON P.,
MOND HARRY G.
Publication year - 2004
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2004.00442.x
Subject(s) - medicine , neurovascular bundle , pectoralis major muscle , implant , fascia , pulse generator , surgery , rib cage , anatomy , physics , quantum mechanics , voltage
The traditional pulse generator implantation site lies subcutaneous on the fascia of the pectoralis major muscle. This article describes a subpectoral pocket approach, which on anatomic investigation is actually “intrapectoral” and offers a much improved cosmetic result with the potential advantage of less erosion. In the authors' experience with over 1,000 initial pacemaker implants and pulse generator replacements, the potential concerns of neurovascular and muscular damage have not been realized. There has been no pulse generator damage from the ribs, serious loculated hematomas, or unusual postoperative or chronic pain. From experience with pulse generator recalls, the replacement procedure has not been significantly more difficult than with the subcutaneous approach. The intrapectoral approach has now become the authors' routine in patients without significant adipose tissue overlying the pectoralis major muscle. (PACE 2004; 27:361–364)