Bakhtawar Shah, Shahab Saidullah.
Implantation Techniques of Permanent Pacemaker: How do we do?.
Ann Pak Inst Med Sci Jan ;11(3):152-6.

Objective: Permanent pacemaker implantation is a popular and unavoidable procedure. We are going to share our own experience in implantation of devices Study Design: Quasi experimental. Place and duration: This study was conducted in Hayat Abad Medical Complex Peshawar June 2009 to June 2011. Materials & Methods We used Deltopectoral (DP) incision, a relatively bloodless area where we hardly used suture, cautery or pressure dressing for control of bleeding, axillary veins approach for placement of leads and sub-cutical suture used to close the wound. Different devices are implanted subcutaneously in aseptic way. RESULTS: Total 261 devices implanted during the study period. Of these 160 were single chamber pacemakers, 101 dual chamber pacemakers, male and female ratio remain as 145: 116. Patient who were in complete heart block were 208. Sick sinus syndrome patient were 17. Sixteen patients were in symptomatic bradycardia. 20 patients presented with Mobitz type II 2nd degree block and were symptomatic. Patient who needed temporary pacemaker urgently were 70. There was no Postsurgical pneumothorax or infection after permanent pacemaker. No bleeding or hematoma was reported after the procedure. The average time of procedure was 45 minutes for dual chamber pacemakers. Conclusion: Permanent pacemaker implantation needs operator skill, knowledge of relative anatomy and fool proof sterilization for successful procedure.

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