Dual chamber pacemaker insertion

PROCEDURE:  Dual chamber pacemaker insertion.

INDICATIONS:  Complete heart block.

ANESTHESIA:  Delivered per anesthesia service via mouth and reports it separately.

PROCEDURE IN DETAIL:  The patient was prepped and draped as usual.  The left pectoralis was approached and copiously infiltrated with lidocaine and Marcaine mix.  The skin incision was carried down to the pectoral pocket which was fashioned without difficulty.  Access was obtained at the thoracic end of the subclavian vein with two separate sticks.  Two 8-French sheaths were used for introduction of the leads into the vasculature which were positioned at intraventricular high septal position and right atrial lateral wall appendicular position.  Adequate thresholds were obtained.  The leads were _____ floor.  The pocket was lavaged thoroughly with antibiotic solution, and the leads were connected to the generator where the pocket was then closed into separate layers in addition to Dermabond with no complications.

TECHNICAL DATA:

The new pacemaker is St. Jude Medical 6826, serial number is 1962153, the right ventricular lead is St. Jude Medical 1788 TC/52 cm lead serial number is BHE 20520, right atrial lead is St. Jude Medical 1788TC/46 cm lead, serial number is BAL 46014.  The P-wave is 2.9, the R-wave is 8.6, impedance of 496 and 584 with a threshold of 1.3 V at 0.5 and 0.9 V at 0.5.  The device prompted DDDR 60/120.

CONCLUSION:  Successful implantation of dual chamber pacemaker system.  No complications _____ postimplant care.