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To the Editor.—
On reading the LETTER by Ali on external support for pacemaker pulse generator it seemed to me that the external support is not necessary. I have been called in consultation for patients with extrused implants. When the implant was replaced, a piece of background of polyester fiber suture (Mersilene) fabric strip was glued to the external surface of the pacemaker and sutured through the adjacent fat and musculature to provide external support for the weight of the pacemaker. This provides adequate support in the patient internally and eliminates the need for any external support in those patients in whom extrusions might be a problem.
Azzato NM. Pacemaker Support. JAMA. 1972;220(1):126. doi:10.1001/jama.1972.03200010110028