Permanent cardiac pacemakers implanted in the pleural space.
Intrapleural implantation is recommended for children, active adolescents and adults, psychiatric patients, and infection-prone patients because of the protection afforded by the pleural space. The implantation technique is briefly described. Complications include diaphragmatic muscle stimulation (with a unipolar unit) and continuous migration of the pulse generator. The advantages of this implantation site include the following (1) reduced risk of lead fracture, (2) protection from physical trauma, (3) reduced risk of infection and erosion. (4) improved cosmetic appearance, and (5) minimized child/generator size disproportion. In one groups of patients undergoing both standard and intrapleural implantation, the number of pacing months per surgical procedure was increased from 5.1 months (standard implant) to 26.2 months (intrapleural implant). Intrapleural implantation may be considered the generator position of choice for the small percentage of patients who require special pacing system protection.
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001146:Arrhythmia, Sinus / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006327:Heart Block / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D010496:Pericardium / Q000601:surgery; D011183:Postoperative Complications; D013903:Thoracic Surgery; D013909:Thorax / Q000601:surgery*