The Journal of Thoracic and Cardiovascular Surgery, Vol 76, 101-107, Copyright © 1978 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Permanent cardiac pacemakers implanted in the pleural space
MF Lynch, NK Jensen and L Urdaneta
Intrapleural implantation is recommended for children, active adolescents
and adults, psychiatric patients, and infection-prone patients because of
the protection afforded by the pleural space. The implantation technique is
briefly described. Complications include diaphragmatic muscle stimulation
(with a unipolar unit) and continuous migration of the pulse generator. The
advantages of this implantation site include the following (1) reduced risk
of lead fracture, (2) protection from physical trauma, (3) reduced risk of
infection and erosion. (4) improved cosmetic appearance, and (5) minimized
child/generator size disproportion. In one groups of patients undergoing
both standard and intrapleural implantation, the number of pacing months
per surgical procedure was increased from 5.1 months (standard implant) to
26.2 months (intrapleural implant). Intrapleural implantation may be
considered the generator position of choice for the small percentage of
patients who require special pacing system protection.
