Pocket creation in the prepectoral subfascial position for the implantation of a cardiac implantable electrical device

Imai, Kyoichi

doi:10.1016/j.joa.2014.02.008

Cited by 10 publications

(11 citation statements)

References 10 publications

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“…For all implant surgeries, there was no prior intervention on the device pocket site. The location of the pocket varied as determined by the operating surgeon, and the implantation was made approximately one third of the distance from the lateral clavicle, as recommended in a previous study 2 . The leads were fixed using a sleeve, and the sleeves were also fixed to the muscle at two points.…”

Section: Methodsmentioning

confidence: 99%

Relationship between device displacement distance toward the caudal side during standing and pocket position laterality

Miyamoto

Oginosawa

Fujino

et al. 2022

Pacing Clinical Electrophis

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Background:The displacement of cardiac implantable electronic devices (CIEDs) toward the caudal side during standing after CIED implantation could cause lead dislodgement. This study investigated the relationship between supine pocket position and standing CIEDs' displacement distance after the implantation. Methods:After CIED surgeries performed at 2 hospitals between 2012 and 2020, 134 patients underwent postoperative chest x-rays in the supine and standing positions during hospitalization. To measure the displacement distance of CIEDs from the supine to the standing position, we identified the first thoracic vertebrae (Th1) in the supine position using the first rib as an index, drew a horizontal line at the lower edge of the Th1, and calculated the distance from that point to the upper edge of the CIED. The difference between measures for the two positions was compared. At the position of the pocket in the thorax in the supine position, the ratio of the distance between the thorax and the device is defined as the device thorax ratio (DTR). We examined the relationship between DTR and CIED displacement distance. Results:In this study, we included 134 patients (53% men; median age, 79 years, body mass index, 22.3 ± 3.4; pacemaker 93%, left implantation 96%). We found that the more lateral the position of the CIED pocket, the more the CIED fell when standing (confidence interval = 0.34-0.60, P < .001). Conclusions:The farther the CIED was implanted outside the thorax in the supine position, the more significantly the CIED was displaced in the standing position.

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Section: Methodsmentioning

confidence: 99%

Relationship between device displacement distance toward the caudal side during standing and pocket position laterality

Miyamoto

Oginosawa

Fujino

et al. 2022

Pacing Clinical Electrophis

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“…35 It is recommended that the pocket can be placed beneath the major pectoralis muscle, especially in Japanese individuals. 36 In Kawatani et al, 33 the thickness of subcutaneous tissue is measured as 2.6 mm, while pectoralis major muscle has 5.6 mm thickness in the ultrasound examination. Thus, the total thickness is around 8.2 mm from the outer skin to the bottom of the pectoralis major muscle.…”

Section: Lc-s Compensation Network and Experimental Measurementsmentioning

confidence: 99%

“…An intramuscular pocket between the pectoral muscular layers may be used for the patients with little subcutaneous fat 35 . It is recommended that the pocket can be placed beneath the major pectoralis muscle, especially in Japanese individuals 36 . In Kawatani et al, 33 the thickness of subcutaneous tissue is measured as 2.6 mm, while pectoralis major muscle has 5.6 mm thickness in the ultrasound examination.…”

Section: Prototype Design Of Wpt Converter With Lc‐s Compensation For...mentioning

confidence: 99%

High‐efficiency LC‐S compensated wireless power transfer charging converter for implantable pacemakers

Çetin

Demirci

2021

Circuit Theory & Apps

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This paper deals with wireless power transfer (WPT) based on magnetic coupling resonance in order to delivery power to a cardiac pacemaker from the outside of the body. The high-efficiency power delivery, implantation, and safety are key parameters for a WPT system, designed for active implantable medical devices. Therefore, this paper is focused on high-efficiency power transfer, implantation, and safety issues. For the wireless charging of the pacemaker, the LC-S compensation topology is presented and designed based on high-efficiency power delivery. The resonant components of the LC-S compensation topology were extracted in order to ensure that WPT converter operates at resonance frequency. The operation of the presented WPT charging converter is validated by a prototype operating at 300-kHz operation frequency. At 4.2 V output voltage and 0.45 A output current, the WPT efficiency of the prototype is measured as 82.39%. Finally, the safety evaluation of the proposed WPT converter is also discussed based on reference values presented in the literature.

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“…To minimize such traumatic pocket complications, prepectoral subfascial implantation has been employed since the early 1990s mainly for large devices ( Fig. 1 ) [31] , [32] , although limited data support this practice. In any and all circumstances, hematoma formation should be avoided by meticulous cautery of bleeding sites since hematoma involving a pocket has been identified as a risk factor in device placement [33] .…”

Section: Prevention Of Cied Infectionmentioning

confidence: 99%

Perioperative management for the prevention of bacterial infection in cardiac implantable electronic device placement

Imai

2015

Journal of Arrhythmia

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Cardiac implantable electronic devices (CIEDs) have become important in the treatment of cardiac disease and placement rates increased significantly in the last decade. However, despite the use of appropriate antimicrobial prophylaxis, CIED infection rates are increasing disproportionately to the implantation rate. CIED infection often requires explantation of all hardware, and at times results in death. Surgical site infection (SSI) is the most common cause of CIED infection as a pocket infection. The best method of combating CIED infection is prevention. Prevention of CIED infections comprises three phases: before, during, and after device implantation. The most critical factors in the prevention of SSIs are detailed operative techniques including the practice of proper technique by the surgeon and surgical team.

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Pocket creation in the prepectoral subfascial position for the implantation of a cardiac implantable electrical device

Cited by 10 publications

References 10 publications

Relationship between device displacement distance toward the caudal side during standing and pocket position laterality

Relationship between device displacement distance toward the caudal side during standing and pocket position laterality

High‐efficiency LC‐S compensated wireless power transfer charging converter for implantable pacemakers

Perioperative management for the prevention of bacterial infection in cardiac implantable electronic device placement

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