This 61-year-old man received a pacemaker at another institution for complete atrioventricular block 9 months before the photograph shown in the Figure⇓ was taken. The patient considered follow-up unnecessary, and he was not concerned when the device began to show through the skin. Only when it fell out, 2 weeks before admission, did he notify his physician. No systemic reaction occurred, and the pacemaker functioned normally. The patient prevented the device from catching in his clothing by holding it against his chest wall with a gauze flat and adhesive tape. Explantation and replacement of a new unit under the pectoral major muscle on the opposite side was accomplished without incident. Cultures of the wound were positive for Staphylococcus epidermidis. At follow-up 6 months later, the wounds had healed and there was no recurrence of infection at either site.
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The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
Circulation encourages readers to submit cardiovascular images to the Circulation Editorial Office, St Luke’s Episcopal Hospital/Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.
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