Subdermal vs Subpectoral
- by sandoval
- 2020-11-26 12:48:58
- Surgery & Recovery
- 923 views
- 3 comments
Fairly new to this site and I've seen subdermal & sebpectoral mentioned. Is this something decided between patient and doc or not ? I'm on a waiting list but no idea if there will be a pre op chat as there wasn't for my ablation back in March.
3 Comments
Device position
by Gemita - 2020-11-26 14:50:19
Sandoval, I agree with crustyg’s comments.
I would learn as much as you can about your choices and then there is no harm asking about what options are available to you. Looking through Pacemaker Club old posts, a deeper placement is cosmetically more acceptable and longer term potentially more comfortable, once you get over the initial hurdle of longer recovery and more discomfort from a deeper placement. Remember in the future it may not be so straightforward to replace the device though and I am not sure whether you can go from subpectoral to subdermal, so there are questions to ask.
I wasn’t given a choice where my device would be placed, but I did have a pre op in my London hospital because my EP wanted to implant under a general anaesthetic. During pre op I was able to chat freely with a doctor about what would be happening during implant and I had all the necessary checks at the same time: bloods, X-ray.
Because of your potential CRT-D pacemaker however, I do feel that you will have the opportunity to be called in prior to your implant. As soon as you get your date through I would ask about a pre-op, so that you can ask lots of questions this time. It sounds as though you really need to do this.
Personally if I may say so Sandoval, I feel that it is more important to focus on getting the right device before you worry about subdermal/subpectoral positioning. The correct device will make such a difference to your quality of life. Maybe the device choice (CRT-P or CRT-D) will determine in any event where the device can be placed? Only my opinion Sandoval, but I hope this helps.
Sun pec
by sandoval - 2020-11-28 22:17:59
Ar_vin - I don't do scrambling or climbing but I carry a golf bag around with the strap over my left shoulder for a few hours a few times a week. Of course I realise I can't play for several weeks anyway so not sure if it would make any difference after the site has healed. I'll ask and see what response I get.
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by crustyg - 2020-11-26 13:21:04
Unless you raise this you'll get your PM placed where it's most commonly implanted.
Your EP doc may well push back on any other placement, and I'm told that sub-pectoral is *much* more painful for the first few weeks. You need to have some compelling arguments/logic/reason why it shouldn't be placed in the usual position. Doesn't mean that you can't get it implanted to a different pocket location, but it's not a simple matter of choosing two equally good locations - it impacts both you and your EP doc.
Search some of the other historical posts about this for other people's experience.
HTH.