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 Sub-pectoral implant 
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Joined: September 2nd, 2006, 10:51 pm
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Location: Terre Haute, IN
Post Sub-pectoral implant
Good morning. O.k. here goes, what exactly is a sub-pectoral implant? How is it different from a regular implant. I am still self conscious about my implant site, looks like a deck of cards under the skin. But it hasn't been a year yet, so hope it will get better, or maybe it was my doctor's way of doing the implant. I don't know.

Somebody maybe could explain a sub-pectoral implant and why do they do such an operation. Thanks. Have a great day! Judy

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Judy Heart attack 6/98, stent implant 8/98, 31% EF, ASCVD, CHF
ICD implant 8/2/06 Medtronic Virtuoso
Diabetes New ICD implant 9/10/09 Angioplasty (two stents) Nov. 5, 2010 Biventricular Consulta implanted March 13, 2013


April 1st, 2007, 9:35 am
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Joined: September 8th, 2005, 12:23 am
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Location: California Bay Area
Post Implant Sites
Well I posted a very long and informative post yesturday on this subject, and when I was finished I could not get it posted because the site was down sooo long -- I have since lost the post!

Sub pect - is under the pectrol muscle. I have mine there for the reason you stated. Mine was implanted in 1999, and was the third to be implanted under the muscle at UCSF Stanford. They started implanting them there in teens for more protection as they play contact sports, also to make more discrete looking. I was concerned about the box sticking out, so they implanted mine under the muscle. I also was concerned about the scarring, so I asked my scar be up and down - not horizontal. My surgeon compromised with that. My scar is diagonal, which fits nicely behind my bra strap or swim suit. So I actaully do go days without even noticing or seeing my ICD. The recovery was a little harder, but well worth it. I was still driving on the third day and no pain meds - only at night. It was muscle sore, with the muscle being cut - gave rolling out of a bed a whole new meaning!

I have since noticed surgeons are listening to and working with their patients. I have seen implant sites through the arm pit in children and young teens. I have seen the implant placed under the breast in young women. I am glad there are Doctors out there who think outside of the box....

I have had a great amount of weight loss in the last year and half, and thank God my unit was up for replacement, because the ICD began migrating out of the pocket, under the muscle. When I had my unit replaced, I asked that the pocket be revised and the unit be tightily anchored into place. They did what I asked. My unit has very little movement under the muscle and you cannot see the outline of the box at all. I just look a little "fuller" on that side if you stop and look and closely. My next replacement I will have a plastic surgeon standing by. As my scar has stretched, being opened up three times in the same spot, and I will have it all cleaned up the next time. It is great to know your options!

Well I hope this has helped answer your question and has provided food for thought for others.

Keep asking questions,
~guin :hrt


April 2nd, 2007, 11:11 am
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Joined: April 18th, 2006, 9:19 pm
Posts: 317
Location: Victoria, BC
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I just got a subpectoral implant on March 5th. I have had two other "pockets" that were not subpectoral in the same year. I got it put this way because I kept wrecking my pocket with excessive paddling exercise. My Doctor was concerned about muscle atrophy that happens when you put it this way, but since I was begging and couldn't live with the ICD flopping about under the skin he went for it.

I certainly did hurt more to get it put in this way BUT it already hurts less. I am a larger woman an my device flopped about everytime I bent over or lay on my back. When I lay on my back the device used to poke me in my neck, I hated that! Yes, the unit is MUCH less visible this way too. I am not very worried about the scars. I have one on my breast (from a failed implant) and a large one under the collar bone. Yes, it has stretched; my own cardiac surgeon tidies this up each time he fixes my pocket. I also bump my implant site a lot, loading kayaks onto car, carrying camping gear, wearing backpacks, so I am hoping it will be more protected this way.

I read about the ICD implant being compared to a chicked breast once, and that really helped me visualize the process. A typical implant is more or less like putting the device under the skin and HOPEFULLY tying it down. A subpectoral implant is like putting the device into the whole breast, muscle and all. I have heard it referred to as an intra-pectoral implant, because it is IN the muscle more so than under the muscle.

For me, I hope this option is more successful. Although I don't look forward to a battery change because it did hurt more. 8) Hope this helps you with your question a little. I would be glad to any any other things you may be curious about.

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Long QT Syndrome.

Jan 28 2006: ICD Guidant Vitality 2 T175 implant
Revisions: Jan 31 2006 (pocket failure), July 25 2006 (pocket failure & device wandering), March 5 2007 (sub-pectoral implant - success!!)
WAIT! April 5, 2007 Guidant ICD recall. October 15, 2007 Sprint Fidelis Lead 6948 recall.

Dec 28 2011: ICD St Jude's Current VR RF Model 1207-36 implant

Implanted in previous sub-pectoral pocket, laser lead extraction, St Jude's Lead installed (T.B.A).


April 2nd, 2007, 1:12 pm
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The replacement is easy Sheila; because they don't cut the muscle again - they just flop one out and plug the new one in... Home in a couple of hours and just a little twinging from the incision. That is it - truly a piece of cake -- I am on my third....

I know you will be happy with your new implant - I can't beleive they didn't do that for you the fiirst time around!
~guin


April 2nd, 2007, 2:42 pm
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Joined: March 17th, 2007, 12:01 pm
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Location: Western New York
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Judy,
I just had my ICD put in under the muscle (or is it actually under the breast?) for pretty much the same reasons as Guin and Sheila. Mostly, I didn’t want it to be noticeable under my skin. I have no idea what it looks like yet, as the bandages are still on. But as far as the pain – it’s not bad at all, a little sore at the end of the day.

This is not standard operating procedure for my EP – he normally implants under the skin. I had to specifically ask that it be done this way, but the doctor was very accommodating. Gina

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April 2nd, 2007, 5:30 pm
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It sounds like they either did not have to cut your muscle Gina, or it is on top of the muscle, but under tissue. You would definately be sorer if they cut your muscle.

When I say implanted under the breast, I mean they make the incision under the breast and actually implant there. Very interesting, if you want it completely out of the way and not a very noticeable scar.

Glad you are doing well Gina.
~guin :hrt


April 2nd, 2007, 7:43 pm
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Joined: October 27th, 2005, 12:12 pm
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Katie had her sub-pec revised the first week of March - it is actually much more visable than before both her initial subcutaneous one and the first sub pec - I think as far as visability our physical size and placement of the ICD come into play at lot. Katie is thin and it was hidden more when it was just under the skin, down more and in toward her armpit. Now it is a little higher and over more and just under the collar bone and you see the outline now that you didnt before.

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Wishing You a Zap Free Day,
Cyndie


(Brugada Syndrome, Long QT Syndrome, Sick Sinus Syndrome, ICD & 2 children one with Brugada, ICD and one with Brugada, Long QT and removed ICD due to staph)


April 3rd, 2007, 12:36 pm
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