Background: Generator-induced shoulder impairment is a common complication of cardiac implantable electronic device (CIED) implantation. Although implantable cardioverter-defibrillators (ICDs) have become smaller in size, they are still bigger than pacemakers (PMs). This study aimed to investigate the effects of single-chamber PM and ICD sizes on shoulder function. Methods: This retrospective study included 200 consecutive patients, of whom 123 had PMs and 77 had ICDs. The CIED implantation effects on shoulder function, pain, disability, and quality of life (QoL) were evaluated. The range of motion (ROM), Visual Analog Scale (VAS), Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), and Short Form-36 (SF-36) Health Survey (Physical and Mental Component Summary [PCS and MCS]) were used. Results:The flexion and abduction range limitation rates were significantly higher in the ICD group than in the PM group (16.9% vs. 7.3%, p = .035 and 19.5% vs. 8.9%, p = .031, respectively). The two groups had similar VAS scores. The median QuickDASH score was significantly higher in the ICD group than in the PM group (8.2 [3.6-19.6] vs. 4.6 [2.6-17.9], p = .034). There were no significant differences in SF-36 components between the two groups. ICD implantation (OR: 1.642, 95% CI: 1.293-2.776; p = .001) and incision length (OR: 1.343, 95% CI: 1.194-2.064; p = .01) were independent predictors of shoulder ROM limitations.Conclusions: Reduced device sizes with advancing technology can decrease shoulder functional limitations and disability after implantation. Healthcare professionals should not neglect shoulder evaluations during the pre-and postimplantation periods.

Background: Shoulder impairment on the implant side is common after cardiac implantable electronic device (CIED) implantation. The aim of this study was to compare the efficacy and safety of the pendulum exercise (PE) and stretching and strengthening exercises (SSE) in preventing postimplantation shoulder impairment. Methods:This prospective, randomized study collected data from 89 patients, including 30 in a control group, 31 in a PE group, and 28 in an SSE group. Shoulder functions on the implant side were evaluated by grip strength (GS), range of motion (ROM), Visual Analog Scale (VAS), Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), and 36-Item Short-Form Survey (SF-36).Results: Shoulder median flexion and abduction ROM were significantly improved 2month postimplantation compared to two-week postimplantation in PE (156 ± 11 vs. 146 ± 10, p = .002; 147 ± 9 vs. 136 ± 9, p = .001, respectively) and SSE (158 ± 13 vs. 147 ± 11, p = .003; 149 ± 13 vs. 138 ± 9, p = .002, respectively) groups, but not in the control group. Two months after implantation, the two exercise groups showed no significant differences in any assessment. Compared with the PE and SSE groups, the control group had significantly lower GS (p = .012 and p = .002, respectively) and SF-36 physical component summary (p = .007 and p = .003, respectively) and significantly higher VAS (p = .003 and p = .001, respectively) and QuickDASH (p = .002 and p = .005, respectively) scores 2-month postimplantation.Conclusions: PE and SSE for the ipsilateral upper arm starting two-week after CIED implantation provided similar benefits in preserving shoulder girdle muscle strength, maintaining shoulder motion, relieving shoulder pain, preventing shoulder injury, and improving quality of life, without the risk of lead dislodgement.

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Purpose Shoulder disorders may occur for procedural reasons in patients fitted with a cardiac implantable electronic device (CIED). This study aimed to examine the effects of CIED implantation on shoulder functions and scapular dyskinesis. Materials and methods Thirty patients fitted with a CIED formed the study group (SG), whilst 30 participants without a CIED formed the control group (CG). The range of motion (ROM), grip strength, lateral scapular slide test (static), scapular dyskinesis test (dynamic), American Shoulder and Elbow Surgeons (ASES) Shoulder Score, and the Short Form-36 Health Survey (Physical and Mental Component Summary [PCS and MCS]) were applied in the study. Results The shoulder’s mean flexion and abduction ROM on the implant side were found to be significantly lower in the SG than the CG (p = .016 and p = .001, respectively). Similarly, a significant grip strength loss on the implant side was detected in the SG than in the CG (p = .036). Static and dynamic scapular dyskinesis frequencies were shown to be significantly higher in the SG than in the CG (p = .002 and p< .001, respectively). The ASES Shoulder Score and PCS score were significantly lower in the SG than in the CG (p = .014 and p = .007, respectively). However, no difference was revealed between the two groups with respect to the contralateral upper limb. Conclusion The frequency of scapular dyskinesis and disability was higher, and upper limb functions, grip strength, and physical subdivision of quality of life decreased in CIED recipients. These findings suggest that such parameters should be included in physiotherapy assessment and treatment programs.