CRT Placement

placement

by Tracey_E - 2024-02-22 17:32:32

I've had both submammary and subpec. They are different. Submammary goes under the breast tissue. Subpec goes between the two pectorals. 

Pro's to submammary, depending on your build it is totally hidden.

Con's to submammary, and why mine was moved, it's very deep so replacements are harder.

Subpec, most people are very happy with this placement. Mine, however, did not stay in place and shifted so now it pokes out when I move my arm. It's still a lot better than the traditional placement, but after so many years of submammary, I find it annoying. I have a new doctor now who offered to put it back deeper, but it's only annoying, not painful, so I chose not to mess with it until the next replacement. Any time they go in there is an infection risk. If it was painful I would have done it, but felt convenience and a bit of vanity weren't worth the extra trouble. 

Another option, again depending on your build, is go a little lower and a little deeper than the traditional placement (just under the skin, just under the collarbone) so it's buried a bit but on top of the muscle, not in it. This is where we were going to move mine to, had I chosen to reposition. 

A few thoughts:

I have a regular 2 lead pacer, not CRT. CRT is considerably larger so burying it may not work as well. It's more likely to end up like mine is, shifiting when I raise my arm. If you are a smaller build, they are probably not going to be able to completely make it disappear. 

Mine was done by a plastic surgeon. Ask your ep about consulting with one. My ep understood that I wanted it out of the way, but he didn't want to mess with it. It was the easiest job of the day for the plastic surgeon. Some surgeons are more open to this than others. 

Last, while we ideally want to not see it or feel it, that's probably not completely realistic. And the reality of it is, it's probably nowhere near as bad as you think it will be. What's obvious to us is likely not noticeable to 99% of the people we meet. This may be hard to believe now, but even if you can see and feel it, most of us quickly reach a point where we don't give it a thought. Make it clear to your surgeon what activities you do and that how it looks is important to you.  Hope for the best, but don't fear if it's not completely hidden. 

p.s.

by Tracey_E - 2024-02-22 17:33:41

I'm one of the moderators. I edited your post to take your email address out of the subject line. 

Hi!

by Lavender - 2024-02-22 18:09:30

I have a Boston Scientific CRT-P and no one would know it's there. It have to look to see the thin scar. No one notices it. The device dimensions:
height is 2.4 in. (6.2 cm)
width is 1.8 in. (4.5 cm)

Thickness is  0.3 in. (0.8 cm)
weight is 1.2oz. (33 g)

Mine stayed put for the three years I have had it. It doesn't stick out. It is placed deep under the skin but is not sub pec or sub mammary. I wear any kind of top. 
 

Backpacking isn't something I do and I think the backpack strap would rub on the pacemaker though. I know others here have adapted ways to backpack. 
 

Check out pics online of Julie Bowen of "Modern Family ". Her pacemaker doesn't show. Discuss your concerns with the dr who will be placing it. 

Thanks

by Andiek11 - 2024-02-23 00:35:28

Lavender and Tracy_E, appreciate the feedback, reality checks, and encouragement.  It  all really helps.  

Andie

by PacedNRunning - 2024-02-24 01:17:56

Mine is hidden well. Mine is about 3-4" below my collarbone to the left of my nipple (sorry for the description) but just to give you an idea.  It just above my breast and the edge is just in line with the middle of my nipple. I only give those landmarks because my first one was closer to my armpit and this one he moved a little more inward.

Both placements are nice.  He placed it deep under every layer of skin and sits on top of my muscle.  You can only see it in certain angles but looking straight at me, you can't see it.  If you are active, under the muscle is not ideal due to stress on the leads from activity.  

My EP was willing to place it under the muscle but preferred not to do this if he could find a good spot to hide it.  From others experience, under the muscle is more difficult for future replacements, more scar tissue and higher chance of quicker wear and tear on leads when you have an active lifestyle. I can say my device does not get in the way of backpacks, purses etc. My sports bra straps go right over it so I found wider straps are more comfortable.  

As previous posters stated, CRT's are larger devices and may be harder to hide. Hopefully your doctor is skilled in placing them well for those wanting them to be less noticeable. My EP seemed to really care more than I did about placement. Make sure they place a minimum of 100 devices per year.  :). Wish you the best!  

Angry Sparrow and Pacednrunning - Sincere thank!

by Andiek11 - 2024-02-24 15:27:32

Ladies - WOW!!  And that's a GOOD wow!  I so needed to see these messages.  I've not yet met my EP but know who I'm being referred to.  My cardiologist used to place these puppies so it very familiar with the issues, etc.  I hope to have a video mtg w/ EP very soon.  I hope to have an actual "installation" date by the end of next week.  

A bit of backstory, I was treated for Breast Cancer (left side) over 33 yrs ago (yep, I was young) and have a variety of mastectomy and reconstruction scars across both the front and back of my upper chest and back to show for it.  In fact the need ro CRT stems from cardio toxicity of one of my chemo drugs, so the fact that I'm even in this position is very emotionally laden. (when will this cancer STOP being part of my life!! grrrrrrrrrr).  At the end of the day, I'm sure I could adjust to "seeing" the CRT, but if there is a way to avoid it I want to.  I don't want the device to limit my life by chipping away at the activities I do and enjoy.  I want the pacemaker to become part of my life story - not direct my life story.  Mostly, I don't want to wake-up for the procedure with "buyers remorse".  Very much a quality of life vs quantity of life.  

Exploring this site is a huge help but has also fueled some anxiety as I read about healing issues, antibiotic "pouches"???, etc, etc.  All part of the experience I expect.  Thanks again for sharing your knowledge and experience!! 

healing

by new to pace.... - 2024-02-24 17:53:05

Not everyone experiences a hard healing.  Mine went well except i found out i was allergic to the glue that was used to close the incision.  Once i was able to get the glue off , no problem.  Developed itchy rash took allergy pill and was ok.

 With your pacemaker you will be able to enjoy life better than before.  Their are many on this site who will tell you so. Since you have lived with your scars this will be minor.

The only thing while healing is not to lift your arm above your shoulder or lift up that milk jug.  Your doctor will give you instructions as what you can or cannot do while healing.  I did get a pad to lift the seat belt off the pacemaker while healing.  Once it healed gave it to someone else to use.

new to pace

😘💞

by Lavender - 2024-02-24 19:45:39

A lot of people are here because they've had issues but the majority of people who get devices are not on this website. They go on with life as normal and adjust quickly. 

I had no issues but moreso curiosity and wanted to learn more. I was anxious at first and felt unprepared but I never had any problems with my CRT-P. I didn't have an antibiotic pouch. My incision healed quickly and disappeared mostly. I did have lingering left arm soreness and strain but it's gone now and I attribute the healing to therapeutic massage.  
 

Your situation will be unique to you. Good thing is if you do need support and advice-here we are 😁

No wonder you're gunshy. You have been through a ton of medical trauma!  This will be a piece of cake compared to what you've experienced with breast cancer. Your pacemaker will enhance your quality of life not diminish it!  
 

I would be angry that a chemo drug hurt my heart but you know they prioritize. You needed chemo to save your life. Your heart is still there and can be fixed with the CRT-P. Breast cancer is scary! You're a survivor and will go on to enjoy life with the insurance policy of a pacemaker. 

New to Pace and Lavender - Thanks

by Andiek11 - 2024-02-25 19:03:58

Appreciate your words of wisdom and encouragement. I'll carry them, along with those shared by others, close to heart throughout this experience.  :)