Abstract
Since 1976 sutureless epicardial pacemakers have been implanted through the subxiphoid approach in 22 patients with complete atrioventricular block or sick sinus syndrome. In 9 (41%) of these patients, complications which necessitated medical and/or surgical therapy occurred and these were analyzed in this paper.
In three patients demand failure due to trouble of pacemaker was observed. Pericardial effusion as post-pericardiotomy syndrome appeared with signs of tamponade in 6 patients. In a 71 year old man with variant angina, the insertion of sutureless electrode resulted in perforation of right ventricular wall and hemorrhagic shock. The bleeding was surgically controlled through additional midsternotomy.
In conclusion, importance of cautious selection of the implantation site without fat and scars was emphasized, especially in such a patient whose myocardium is feeble as is aged or suffered from ischemic heart disease. Pericardial effusion tends to appear in the patient with severe illness in addition to heart disease.
