Under pec muscle

I asked about getting a micro device but since I have an older style Medtronic device they said surgery would be brutal removing the leads etc. They suggested a new device placed under the pectoral muscle so I wouldn't see it.  Anyone have this done and was healing easy as before?



by Tracey_E - 2024-03-05 11:13:49

1. They are now starting to do leadless devices without removing existing leads. Not a lot of cases and it's very new, but it's happening.

2. Is there a particular reason they think you are particularly high risk to remove the leads? I don't like the word brutal. It makes it sound like they are going to yank them out. They go in with a laser and remove them mm by mm. Tedious, and a serious surgery, but not generally considered high risk when done by someone experienced.  They're only 15 years old,which isn't great but it's not necessarily awful either. You might consider being evaluated by someone who specializes in extraction. Caveat, if your leads are in good shape, I'd leave them alone until they need replaced. That's just me tho. 

3. My current one is subpec. Healing is most definitely not as easy as subcutaneous. It's not awful, but it is not the same as when it's under the skin.

Depending on your build, they may be able to put it a little lower and a little deeper than where it is now so that it's more buried but not under muscle. That would be an easier recovery.

A lot of people like subpec, some find it bothers them. I am very active. Mine shifted and now it slides around and pokes out when I raise my arm. They stitch them in place but I guess mine didn't hold. It's annoying but not painful so I chose not to have it repositioned. But I definitely will not have my next one under muscle. I'll need a new one later this year. We are discussing moving to leadless, or if we stick with traditional it will go on top of the muscle. 

Removal of leads

by Brantfordmuscle - 2024-03-06 17:14:57

They just said definitely more complicated because they'd need a heart team available just in case of complications. They said also the micro devices are way more expensive and typically they do them if it's you're first one.  Anyway I'm going with sub pectoral but am a bit concerned about building muscle afterwards.  I'm muscular and would like to keep building chest and arms.

working out with subpec

by Tracey_E - 2024-03-06 18:46:07

Mine was put in subpectoral in 2015. I was doing daily Crossfit before and continued until two years ago. I stopped due to joints, not my heart or the pacer. It took a good 3-4 months after before I was back to my full routine without any residual discomfort. It didn't hurt that long, but that's about how long I was aware of it and babied it. 

Extraction is always done by a specialized team with a cardio-thoracic surgeon in the OR. That's standard. 

subpec placement

by islandgirl - 2024-03-06 21:44:12

My ICD was placed subpec just over a year ago.  My first device was placed a little deeper but eventually would slide over to under my arm pit.  The pocket had stretched and the pocket was stitched for the 2nd device.  

A cardio-thoracic surgeon that only works on difficult heart device cases told me there is a pocket and it's also attached at the top and is tethered so it moves slightly with my movements.  So far I'm very happy with it.  

Yes, healing takes longer, and the surgeon said it would take about a year.  The pain for implantation was a little bit more painful.  I would have it placed subpec again.


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