Pacemaker Contact Sensitivity: Case Report and Review of the Literature

Abstract

Pacemaker contact sensitivity is a rare condition. Less than 25 reports of pacemaker skin reaction have been described over the past 30 years. This report describes one patient who developed contact dermatitis after implantation of two subsequent pacemakers. The diagnosis was made with skin patch tests that were positive to polyurethane 75D and polysulfone beige, two of the pacemaker and connector components. Review of the literature and general guidelines for the management of this unusual condition is depicted in this report.

Allergic Response to Pace Maker with Non Healing Wound

“…Treatment is removal of offending agent. Other options are complete coating of offending agent in a proven non-allergic substance documented by patch testing (9). Though discharge in pacemaker allergy is rare, it was seen in our patient.…”

“…Patient was put on empirical course of steroids which resulted in rapid healing of the pocket site. In world literature there have been dismal results of steroids in such situations and steroids increase the possibility of false negative test if administered before patch testing (9,11).…”

Hypersensitivity Reactions to Implanted Metal Devices: Facts and Fictions

“…Allergic reactions to pacemakers and ICDs primarily involve localized pain or dermatitis that presents within 2 days to 24 months after implantation, with occasional reports of generalized pruritus that resolved with the removal of the pacemaker [18,119,120]. Other measures to manage hypersensitivity reactions include control of local dermatitis with topical corticosteroids, replacement of the device with one that does not contain the suspected allergen, such as customized silicone or gold-coated pacemakers [17,[121][122][123], and wrapping the device in a PTFE sheet [124][125][126][127][128].…”

Common Pacemaker Problems: Lead and Pocket Complications

“…Some patients may respond to topical corticosteroids (Viraben et al, 1995). But replacement of the device for one that is free of allergenic components or wrapped with an inert coating is the treatmnet choice (Déry et al, 2002).…”