Gold-coated pacemaker implantation after allergic reactions to pacemaker compounds.
An 86-year-old man underwent pacemaker implantation for symptomatic atrio-ventricular block grade 2 Mobitz II. The patient suffered repeated admissions for iterative sterile wound necrosis, leading to two generator re-implantations. No bacterial infection was detected in the microbiological screening tests. The skin patch testing to titanium was negative. Nevertheless, we decided to remove the pacemaker system and to implant a gold-plated generator with polyurethane leads. Since then, there has been no recurrence of wound complications. Gold-plated generator and polyurethane leads are effective in treating allergic reactions to pacemaker system components in selected cases. Negative skin patch testing to titanium does not exclude allergic reaction to this pacemaker component.
Syburra
Thomas
T
Cardiac Surgery Division, City Hospital Triemli Zurich, Birmensdorferstrasse 497, CH-8063 Zurich, Switzerland. thomas.syburra@triemli.stzh.ch
Schurr
Ulrich
U
Rahn
Mariette
M
Graves
Kirk
K
Genoni
Michele
M
D000369:Aged, 80 and over; D054537:Atrioventricular Block / Q000628:therapy*; D006046:Gold; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology* / Q000628:therapy*; D008297:Male; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D012882:Skin Tests; D014025:Titanium / Q000009:adverse effects*; D016896:Treatment Outcome
D006046:Gold; D014025:Titanium