Pocket revision

Hi all,

I was wondering if anyone on here has has a pocket revision for their pacemaker and what kind of recovery it takes. My pacemaker is about to poke through my skin, you can see lead wires and whenever something just grazes arcoss my skin it feels like a razor blade going over it. The plan is to have it put under the pectoral muscle. I have my consult with the surgeon next monday so I will be able to ask questions but I was just trying to get a little information before I go. I am pacemaker dependent now so my EP dr told me that they will have to hook up a temp PM while they work on the other one and also said that its not just a quick surgery and we also have to hope for no infection. I am just curious as to how other people have gotten along with this, and how long it takes to recover.

Thanks! Holly

8 Comments

Daisy................................

by Tattoo Man - 2013-05-13 01:05:23


......................as ever, a lot of well informed stuff above here !

I had a box revision in Dec and a complete box and leads removal proceedure in Jan.

I had a box infection and my Doc decided to put a new box and leads in my right shoulder...so now, yours truly has a really well stuck in RH Box which is totally perfect...the wierd thing is that the old LH site is the one that I get twinges from..and there isnt anything there !

Re Infections, I dont know about you ot over the Pond but here in the UK the Doc MUST tell you about infection risks as a matter of protocol...ok lets be cynical and say that its all about insurance liabilities...so please dont get too worrried about infections..if they take it seriously then you, as the Patient, should be happy.

When they hauled out my old LH Box they packed me full of antibiotics before stitching me up...a good old case of 'Belt and Braces'.......thats just fine by me !!

I took 6 weeks off heavy arm work and all is just fine.

Daisy..keep us posted.

Tatoo Man

sheesh

by Tracey_E - 2013-05-13 01:05:43

Your doctor has no idea how to talk to people! Burying it and revising the pocket is not high risk for infection, no more so than any other surgery. It's not a super quick surgery but it's not exactly long and drawn out or high risk, either. I had my pocket rebuild and a new lead put in with my last replacement, it took under an hour.

Mine is buried. It's been in the same place all along but my last replacement (4th) we brought in a plastic surgeon to clean up the scar tissue and rebuild the pocket because it was starting to ache. I guess that's comparable to a pocket revision? I was reasonably sore for a few days, felt quite a bit better and was cautiously going about my daily life by a week. I never took anything stronger than Tylenol after I was released from the hospital.

Ask them if the temporary pm will be external or the kind they do through the groin. I've seen several others post about the second type. I'm fully dependent, in all my replacements I've never had that, just an external. Not to be too, um, descriptive, but they don't have to disconnect the pm to clean up the pocket. They can take the old one out, do the work while the old one is still pacing, connect the new one, put it in. I would push for the external because it's one less thing to recover from.

TraceyE

by daisy0388 - 2013-05-13 02:05:01


From what my EP dr told me they would insert a catherter in my groin to hook up the temp pacemaker what they worked on the pocket. I'm sure I will get lots more info when I go for my consult next monday.

The odd thing is when I got my first pacemaker it was well buried, that was july of last year. In dec they put in a dual chamber and for some reason this one sticks out way more but it was 2 different drs that did the surgeries.

Tatoo...I'm glad that your "box" is good now LOL. That made me laugh, I guess I never thought of it as a box. I doubt I will have to have anything done with the leads as they are not old at all. Our drs over here over the pond at USA always go over all the risks and infection of every surgery also but I did wonder why he expressed infection more so then he has in the past.

ask

by Tracey_E - 2013-05-13 03:05:03

I'd ask more questions! Try to talk your way out of the temp if you can. It's not that big a deal, but if you can avoid it, why not?

Is the dual lead larger? Could be it didn't fit in the original pocket.

Good luck!!!

Maybe

by daisy0388 - 2013-05-13 04:05:36

I think my dual pacemaker is probably a little larger but not much. I was just more concerned about how painful it might be and the recovery only cause my daughter is graduating here in a couple of weeks so I have been very busy plus also we plan to take a vacation so I just want to try to time things right so I don't feel horrible while on vacation.

Yep

by Yakkwak - 2013-05-13 05:05:08

Revision done after replacement because first EP made the incision look like the top of. drawstring purse! Fired him, went to his partner in another location and even he agreed it was absolutely horrible. Fixed me up beautifully even though it had to be repositioned a bit. Same recovery. Infection is always an issue but barring a complication, you should be ready to dance. ;-)

revision after 5 months

by JustKrs - 2013-05-13 11:05:20

i had my first pacemaker implanted April 2012, and my pocket revision september 2012. But they just moved the pocket up by 3 inches... mine is still between the muscle and skin, NOT under the pec like you are discussing.

For me it was much less painful and less severe then the original placement. I think my body was much less grumpy about soft tissue changes then it was to have the leads screwed into my heart.

AngrySparrow

by daisy0388 - 2013-05-13 12:05:06

Hi,
My EP is not the same dr that is doing the pocket revision and from what I remember about the infection issue he said that you can always get infection from any type of surgery but he just kind of acted like since I am pacer dependend now that they especially have to becareful of infection, but like you, that should be a common practice anyway. I have done alot of reseach on this dr that is suppose to be doing this. He is a cardiovascular surgeon and the pocket revision and lead revisions are his speciality and the hospital is one that I have been to a few times for my ablations so I am pretty confident as far as the hospital.

I just have a medtronic dual chamber, no ICD, and they are going to do it on the same side. Like you, I am a small, petite thing so I really don't have alot of room up in the chest area but mine looks horrible! Mine also does still itch alot!

I am going to do some search for some pics and see what mine looks like compared to others. Thanks so much for the info, I will keep you udated.

Thanks Holly

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