A Case of Repeated Pacemaker Implantation to Treat Pacemaker Dermatitis

(Department of Cardiovascular Surgery, Fukushima Medical University, Fukushima, Japan)

Yuki Seto Hiroyuki Satokawa Yoichi Sato
Shinya Takase Hiroki Wakamatsu Hiroyuki Kurosawa
Eitoshi Tsuboi Takashi Igarashi Akihiro Yamamoto
Hitoshi Yokoyama
An 84-year-old man, who had been given a diagnosis of advanced aortoventricular block 2 years previously, underwent implantation of a pacemaker(PM)through the left subclavian vein. However, 7 months later a skin ulcer developed at the implantation site, but without any evidence of bacterial infection. Therefore, a PTFE-covered PM battery was reimplanted at the same site. Three months later, the skin ulcer recurred and he received a third implantation in the right side. However, another skin ulcer with infection developed in the right side. He was then transferred to our hospital for another PM reimplantation. We covered the battery and the entire lead with PTFE, then placed the PM lead directly into the cardiac muscle, and implanted the PM battery below the rectal muscle under general anesthesia. A patch test 4 months later revealed a positive reaction to nickel and silicon. Finally, we diagnosed pacemaker dermatitis. The patient has remained free of skin ulcers for over 1 year.
  Jpn. J. Cardiovasc. Surg. 40:140-143(2011)

Keywords:pacemaker dermatitis, polytetrafluoroethylene, contact sensitivity