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Lead erosion in permanent pacemaker: a cumbersome complication.

Bakhtawar Shah¹, Zahid Aslam Awan, Zahoor Ahmed Khan

¹Department of Cardiology, Hayatabad Medical Complex, Peshwar, Pakistan. drbakhtawarshah@hotmail.com

Journal of Ayub Medical College, Abbottabad : JAMC

|January 22, 2015

Summary

Lead erosion in pacemakers is a difficult complication. Careful three-layer lead burial during initial implantation can prevent premature device replacement.

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Area of Science:

Cardiology
Medical Devices
Surgical Complications

Background:

Lead erosion is a significant complication of pacemaker implantation.
It often necessitates premature device explantation and replacement.
Effective prevention strategies are crucial for patient outcomes.

Purpose of the Study:

To evaluate the incidence of lead erosion in pacemaker patients.
To assess the effectiveness of different surgical techniques in preventing lead erosion.
To identify an optimal method for lead implantation to minimize erosion.

Main Methods:

A retrospective study of 415 pacemaker implantations from 2005 to 2011.
Patients were followed regularly, with wound site inspection and device analysis.
Surgical strategies included two-layer closure and submuscular lead burial.

Main Results:

Three cases of lead erosion occurred during the study period.
Two of these cases experienced recurrent erosion despite repositioning and submuscular burial.
The implemented change strategies for lead placement proved unsuccessful in preventing recurrence.

Conclusions:

Careful three-layer lead burial is essential for preventing pacemaker lead erosion.
This technique involves initial muscle implantation, followed by subcutaneous placement, and skin suturing.
Proper initial implantation technique can reduce the incidence of lead erosion and subsequent complications.