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Article
April 1, 1974

Late Displacement of Cardiac Pacemaker Electrode Due to Heavyweight Pulse Generator

Author Affiliations

From New York University School of Medicine, Department of Surgery, New York.

JAMA. 1974;228(1):74-75. doi:10.1001/jama.1974.03230260048025
Abstract

ENDOCARDIAL pacing has been shown to be a satisfactory method for long-term cardiac pacing. The electrode complications of malposition, displacement, fracture, migration, and perforation have been well described in previous publications.1,2 We have recently observed a retraction of the endocardial electrode by the downward migration of the heavy pulse generator. This complication is prevented by anchoring the pacemaker to the clavicle or by creating a pacemaker "pocket" under the pectoral muscle or both.

Report of Cases  A 78-year-old man was admitted to New York University Hospital with intermittent heart block requiring cardiac pacing. A Medtronic pacemaker weighing 200 gm was inserted in a subcutaneous infrapectoral pocket with a bipolar electrode inserted via the cephalic vein into the apex of the right ventricle. Postoperatively the patient did well until the 12th month when failure of capture was noted.Chest x-ray film showed retraction of the catheter into the right atrium

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