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The Journal of Thoracic and Cardiovascular Surgery, Vol 89, 136-141, Copyright © 1985 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

The exposed cardiac pacemaker. Treatment by subfascial pocket relocation

R Garcia-Rinaldi, JM Revuelta, L Bonnington and L Soltero-Harrington

Ten patients were treated for skin erosion and exposure of chronically implanted pacemakers. The pulse generators had been implanted either subcutaneously or in the subpectoral, submammary location. All patients were treated either by primary or secondary relocation of the pulse generator to deeper subfascial planes. Pacemakers relocated primarily to subfacial planes healed without resurfacing. Those pacemakers relocated to other superficial planes resurfaced but healed in a second subfascial translocation. Bacteriologic studies on these patients revealed that the organisms cultured or antibiotics utilized did not influence the fate of the relocated pulse generator. The subfascial location was the only determinant of the ultimate healing of the exposed pacemaker. We conclude that subfascial relocation of well- functioning pacemaker generators should be considered as an alternative to complete replacement of the unit.


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