Subpectoral pacemaker implant after repeated pocket complications due to "senile pruritus"

Abstract

Complications that can occur after pacemaker implant may be surgical or programming function related. We report a case of an 89-years old patient with slow atrial fibrillation, initially treated by external temporary pacing, and then by permanent pacemaker implant. The clinical course in the first months after procedure was uneventful, but after a half-year from the first admission, the patient addressed for pacemaker pocket infection, complaining of intense pruritus. After the drainage of the purulent secretions, the patient developed pocket hematoma, despite of Velpeau bandages and antipruritic drugs. Being a non-compliant patient with high risk of reinfection, it was decided, four days later after hematoma evacuation, to relocate the device on the same side, beneath pectoralis major muscle. This case presents two of the device pocket surgical complications (infection and hematoma) that occurred long after the implantation procedure due to senile pruritus.