SUBMAMMARY PACEMAKER IMPLANTATION - A UNIQUE TUNNELING TECHNIQUE

Submammary pacemaker implantation offers women a cosmetically acceptab le alternative to the standard pectoral implant. Mle present a novel m ethod of submammary implantation performed on ten women aged 13-54 yea rs. The lead electrodes are tunneled from the infraclavicular to the i nframammary incision using a long needle, guidewire, and introducers/d ilators in a manner analogous to the retained guidewire technique used for standard lead insertion. The procedure can generally be performed under local anesthesia. All patients tolerated the procedure well wit hout acute complications. Over 2- to 23-month follow-up, there were no lead dislodgments. No patients developed mastitis or incisional compl ications, and all have been extremely satisfied with the cosmetic resu lts. With proper technique, submammary pacemaker implantation can be p erformed under local anesthesia with minimal patient discomfort and op timal cosmesis.