Permanent transvenous pacemaking for senile heart block

Surgical complications of implanting pacemakers

“…Analysing the figures from 21 authors (Edhag and Lagergren, 1969;Witte et al, 1969;Fishman et al, 1970;Goldman et al, 1970;Seling and Sykosch, 1970;Shepard et al, 1971;Dixon et al, 1972;Imparato and Kim, 1972;Conklin et al, 1973;Homan van der Heide et al, 1973;Kantrowicz et al, 1973;Linschoten et al, 1973;McLaughlin et al, 1973;Mascarenhas and Center, 1973;Seremetis et al, 1973;Torresani et al, 1973;Codini et al, 1974;Sowton et al, 1974;Uhrenholdt et al, 1974;Williams et al, 1974), each of whom have reported 10&800 implantations in the past 5 years, the mean figure for surgical complications is 5.1 per cent in 7205 implants. (This incidence may be an underestimate as not all the reports indicated whether they included skin necrosis with infection.)…”

“…In others the only lesions to explain bacteraemia were a paronychia (Codini et al, 1974), a chest infection 2+ months after implantation (Waisser et al, 1972) and a sacral decubitus ulcer (Schwartz and Pervez, 1971). In the Surgical complications of implanting pacemakers remainder clinical details on this point were not given (Bergovich and Fenig, 1970;Fishman et al, 1970;Torresani et al, 1973;Radford and Julian, 1974).…”

“…An analysis of a number of reports on the management of infected pacemaker pockets shows that treatment with parenteral antibiotics will not usually sterilize the pocket without resiting the pacemaker (Firor et al, 1968;Fishman et al, 1970;Seling and Sykosch, 1970;Dixon et al, 1972;Furman et al, 1973;Linschoten et al, 1973;Codini et al, 1974). If the pacemaker is not to be moved the most successful treatment appears to be frequent local irrigation with neomycin or kanamycin.…”