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Left Axillary Pacemaker Generator Implantation with a Direct Puncture of the Left Axillary Vein
Author(s) -
NORO MAHITO,
ZHU XIN,
TAKAGI TAKAHITO,
SAHARA NAOHIKO,
NARABAYASHI YURIKO,
HASHIMOTO HIKARI,
ITO NAOSHI,
ENOMOTO YOSHINARI,
NAKAMURA KEIJIROU,
KUJIME SHINGO,
SAKAI TUYOSHI,
SAKATA TAKAO,
SUGI KAORU
Publication year - 2015
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/pace.12500
Subject(s) - medicine , axillary vein , cardiology , left atrium , surgery , atrial fibrillation , thrombosis
Background Pacemaker generators are routinely implanted in the anterior chest. However, where to place the generator may need to be considered from the mental, functional, and cosmetic standpoints. Methods In this study, we performed the left axillary pacemaker generator implantation with a direct puncture of the left axillary vein in 40 consecutive patients, and evaluated the late safety and efficacy of this implantation. Complications, changes in the lead sensing, pacing threshold, and impedance were used as safety indexes for a mean follow‐up of 3.4 years. In addition, the efficacy was also evaluated by comparing their questionnaire survey results to 119 patients in a control group of anterior chest implantation. Results Lead dislodgements were observed in two patients of the experiment group. There were no migrations of generators from the implantation site or abnormal variations in the pacing threshold, lead sensing, or impedance. In the left anterior chest and left axillary groups, 85% and 10% of the patients were worried about an external impact, 80% and 25% were worried about electromagnetic interference, and 68% and 0% answered that the pacemaker implantation site was noticeable, respectively. Apparently, more patients had a sense of security and cosmetic satisfaction with the left axillary implantation. Conclusion The left axillary generator implantations may reduce the mental burden and cause no safety concerns, and may be performed if functional or cosmetic outcomes are required.