How to Make a Submuscular Pocket

@article{Pea2006HowTM,
  title={How to Make a Submuscular Pocket},
  author={Rafael E. Pe{\~n}a and Richard K. Shepard and Kenneth A. Ellenbogen},
  journal={Journal of Cardiovascular Electrophysiology},
  year={2006},
  volume={17}
}
Today, most devices are placed in the prepectoral location in a procedure that has evolved to become safe, fast, and routine. However, at times patients will be encountered who require placement of a pulse generator below the muscle. Such patients may be identified by a low body mass index, depleted fat stores, and lack of adequate subcutaneous tissue to adequately cover the device. These patients are at high risk for device erosion. Another candidate for submusclar device placement would be a… Expand
Reimplantation of a Pacemaker into a Subpectoral Pocket Via the Lateral Approach in Collaboration with Plastic Surgeons
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This case showed that creating a subpectoral pocket in collaboration with plastic surgeons is quick and safe and unable to implant leadless pacemakers at their hospital due to lack of sufficient skill. Expand
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  • Medicine
  • Pacing and clinical electrophysiology : PACE
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TLDR
Relocation of prepectoral leads and generator to a submuscular pocket for relief of erosion and pain with minimal pectoral trauma is possible by applying a variant of a previously described submammary tunneling technique. Expand
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References

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The Subpectoral Pacemaker Implant:
TLDR
A subpectoral pocket approach is described, which on anatomic investigation is actually “intrapectoral” and offers a much improved cosmetic result with the potential advantage of less erosion. Expand
Pectoral Cardioverter Defibrillators: Comparison of Prepectoral and Submuscular Implantation Techniques
TLDR
For exclusive pectoral implantation of transvenous ICDs, electrophysiologists should master both prepectoral and submuscular techniques to avoid potential skin erosion or need for abdominal implantation in patients with a thin layer of subcutaneous tissue. Expand
The subpectoral pacemaker implant: It isn’t what it seems! Pacing Clin Electrophysiol 2004;27:361-364
  • 2004