Pacemaker Placement

I'm five months post CRT pacemaker. I have concerns as to how close under my skin the device sits. I can literally feel the hard edges on all sides. It's also got a higher "profile" and I have already accidentally bumped it on a hard surface and wow did that hurt!! 

Had anyone's surgeon discussed how close to the outer skin the device would sit and why? What's been your experience?  The only thing my surgeon told me with regard to placement, was that everyone's anatomy is different. That's the short answer I guess.  


6 Comments

Placement

by PortCityPacer - 2024-10-28 11:14:34

Sounds like you and I are in the same boat, I am almost 4 months post implant for my CRT  PM and now that all the swelling is gone I too can feel the sharp edge where the leads plug in, seems to be only skin deep and I've been a little fearful of it breaking through the skin from irritation. The area is very sensitive and I mentioned that to my EP, she didn't seem concerned as she poked and prodded the area. Probably once the pocket and incision are fully healed the sensitivity will be less, she said the tissue and nerves are still finding their way back together. My biggest problem is my seatbelt goes directly over the PM, I tried a number of available cushions and stuff, and they helped but finally I made my own device similar to an oblong donut that I wear under my shirt and it has been a great relief.

Pacemaker placement

by Selwyn - 2024-10-28 11:17:22

Hi Meemaw,

If you look at Members Only> Members Gallery> Selwyn     you will see a photo of my pacemaker visible under the skin and the leads coming off it also visible under the skin.  I really need to get some subcutaneous fat!  How many of us can feel our leads?

The surgeon typically makes a pocket between the skin and the chest  muscle in what is called the fascia layer ( connective tissue).  You can have an implant below the muscle - this is more traumatic at the time.

As long as the skin over the implant remains healthy you haven't got a problem. Don't fiddle with the pacemaker as this leads to problems. 

Pacemakers can be placed elsewhere ( eg. at the side, in kids over the abdomen).  I had the choice between left and right sides. ( Seatbelt driver or passenger).

I find that my rucksack straps dig into the pacemaker and can be a bit of a problem. I have a male friend who greets people by a friendly thump to the front of the chest - I have discouraged this ! Passenger seat belts need to be adjusted carefully.

You can buy ( on this site) pads and protectors to go over your PM if you have a trauma risk or discomfort. 

Keep an eye on the skin. Perforation is rare.

Placement

by piglet22 - 2024-10-28 13:12:09

It's quite normal to be able to feel the device and the leads.

I think I have only about 5-mm of skin and tissue covering the generator and then not much further down are the ribs.

I can trace the leads all the way to where the collar bone sits and there's a noticeable bump at that point which I presume is a suture.

The Medtronic generator has a suture hole at the top, close to the connector.

Perhaps if you ask, you might get a copy of the fluoroscope stills to show you exactly where everything is. They sent me four images on a CD.

Hi

by Lavender - 2024-10-28 17:23:33

It's ok. Your device is sustaining you. It's important that you don't touch it or feel around it. Let your trust be in that it's there to help no matter how obvious it seems. I was told it would be buried as deep as possible but wasn't offered sub pectoral placement. Mine isn't noticeable but I can feel the entire device. Believe me, in time, it just becomes part of you. You accept it and actually ignore it. You're still in the getting used to it phase. You can't go back-only forward. ๐Ÿ˜‰

Hope it stops concerning you soon. ๐Ÿงก๐ŸŽƒ

Pacemaker placement

by Aberdeen - 2024-10-31 12:25:16

I can feel my CRT pacemaker and leads under my skin and they seem to be close to the surface. 4 years after implant it doesn't bother me anymore.

I am sure you will get used to it soon. Good luck!

Placement

by Meemaw - 2024-11-01 03:36:34

Piglet22:  i did see a scan of the device and leads. I hope the intermittent nerve pain episodes are fewer in time.  It's also very high profile that will likely be a risk of injury at some point. Thank you for your input.  

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