Subpectoral Technique of Pacemaker Implantation -Reduction of Cost and Length of Hospital Stay-

Abstract

Objective: To reduce the length of hospital stay for patients undergoing pacemaker surgery. Patient and Methods:We prevented the leads from dislodging by anchoring a screw-in type pacing lead in the right atrium/ventricle through a cephalic vein that was cut down. We retrospectively compared the cost and duration of the hospital stay for the subpectoral technique ( Results:The mean (± SD) duration of hospital stay was 5.1 ± 2.1 days for the subpectoral technique group and 22.2 ± 15.2 days for the conventional technique group (P < 0.001), and the cost was 2,167,883 ± 147,549 yen in the subpectoral technique group and 2,528,053 ± 217,810 yen in the conventional technique group (P < 0.001). We noted no major complications such as bleeding, lead dislodgement, or wound infection. Conclusion: Our novel subpectoral technique helped reduce the length and cost of the hospital stay associated with pacemaker surgery.

Pace Maker Implantation for Elderly Individuals Over 90 Years Old

“…It is important to be very careful to prevent wound infection in pacemaker surgery, especially for elderly patients 2 , 6 ) . Elderly patients have a thin subcutaneous fat layer.…”

“…From January 2005 to December 2012, we performed 300 surgeries to implant pacemakers. We applied a technique involving creation of a subpectoral pocket, cutdown of the cephalic vein, use of screw-in leads (SJM Tendril series) and use of a generator with an automatic output system 2 ) . We use tumescent local anesthesia (TLA) in order to eliminate wound pain during and after the surgery 2 ) .…”

“…We applied a technique involving creation of a subpectoral pocket, cutdown of the cephalic vein, use of screw-in leads (SJM Tendril series) and use of a generator with an automatic output system 2 ) . We use tumescent local anesthesia (TLA) in order to eliminate wound pain during and after the surgery 2 ) . Our surgical technique enables us to perform a day surgery or surgery with 1 night admission 2 ) .…”

“…We use tumescent local anesthesia (TLA) in order to eliminate wound pain during and after the surgery 2 ) . Our surgical technique enables us to perform a day surgery or surgery with 1 night admission 2 ) . In our hospital, cardiologists see and examine most of patients when they first come to the hospital.…”

Subpectoral pacemaker implant after repeated pocket complications due to "senile pruritus"

“…Sometimes subclavicular pocket is not suitable for all patients, such as pediatric population or cachectic patients, with very thin subcutaneous tissue, where device implant may become an unpleasant visible deformity [2,3]. In these cases, or in the presence of pocket complications such as infection, pain, palpability, or exposure, plastic surgeons may be consulted for reimplanting the device using a subpectoral approach [4].…”