Why the study?
The aging population, particularly thin and frail patients, has an increased risk of long-term cardiac implantable electronic device complications.
Pacemaker pocket erosion in thin, elderly patients may be mitigated by using submuscular pockets, increasing pocket size, and avoiding superficial fixation sutures.
Requires caution with pocket size and suture depth in thin elderly patients; case report leaves open optimal techniques for validation.
The aging population, particularly the thin and frail, has an increased risk of long-term cardiac implantable electronic device complications. This case is that of an elderly, thin-skinned patient who presented with a pacemaker pocket erosion 4 years after elective generator change, potentiated by a small pocket size with a superficial suture fixating the generator in the subcutaneous pocket. The risk for device erosion may have been mitigated during the generator change by increasing the size of the pocket, using a submuscular pocket, and potentially an absorbable antibacterial envelope. Fixation of the generator is considered optional.
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Vandenberk et al. (2022) studied this question.
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