Gold-coated pacemaker implantation for a patient with type IV allergy to titanium

Abstract

A 65-year-old man was scheduled for pacemaker implantation for symptomatic sick-sinus-syndrome (SSS). He suffered from multiple drug-allergies and allergies to several metals like quicksilver and titanium. Gold-coated pacemaker generators and polyurethane leads are effective in avoiding allergic reactions to pacing system components. Therefore, we decided to implant a custom-made gold-coated DDDR-pacemaker generator and polyurethane leads.

Allergic reaction to pacemaker compounds: Case reports

“… 5 , 8 To date in most of the case reports, the definitive treatment has been the implantation of a pacemaker generator covered with gold, silicone, or PTFE manufactured during the procedure. 1 , 2 , 6 , 8 , 9 , 10 , 11 , 12 , 13 , 14 …”

“…5,9 To date in most of the case reports, the definitive treatment has been the implantation of a pacemaker generator covered with gold, silicone or PTFE manufactured during the procedure. [1][2]6,[8][9][10][11][12][13][14] Of the cases we report here, the first one was implanted with a gold-covered pacemaker generator and the other two were wrapped in ePTFE; none of them have shown allergy data again during their follow-up. In our experience, the use of PTFE has provided an adequate alternative since it is a much more viable material and no allergic reactions have been reported despite its greater use in other surgical procedures.…”

First-in-man implantation of a gold-coated biventricular defibrillator: Difficult differential diagnosis of metal hypersensitivity reaction vs chronic device infection

“…To our best knowledge, this is the first case of implantation of a gold-coated biventricular defibrillator. 13 Owing to the sparse literature, we discussed the problem in the membership forum of the Heart Rhythm Society and got valuable contributions from the participants. Proposed solutions included not performing a new implantation, which seemed to be not suitable with regard to the clinical effect.…”

Hypersensitivity Reactions to Components of Cardiac Implantable Electronic Devices and Their Treatment: A Systematic Review

“…28 In addition, one patient was known to have a titanium allergy and was implanted with a gold coated pacemaker at the index procedure. 29 Full descriptions of presenting reactions are detailed in Supplementary Material Table 1. 9,…”