title: Gold-coated pacemaker implantation after allergic reactions to pacemaker compounds.
abstract: 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.
authors.affiliation: Cardiac Surgery Division, City Hospital Triemli Zurich, Birmensdorferstrasse 497, CH-8063 Zurich, Switzerland. thomas.syburra@triemli.stzh.ch
authors.forename: Thomas
authors.initials: T
authors.lastname: Syburra
authors.forename: Ulrich
authors.initials: U
authors.lastname: Schurr
authors.forename: Mariette
authors.initials: M
authors.lastname: Rahn
authors.forename: Kirk
authors.initials: K
authors.lastname: Graves
authors.forename: Michele
authors.initials: M
authors.lastname: Genoni
mesh_terms: 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
chemical_list: D006046:Gold; D014025:Titanium