A pilot study comparing two sites for incision during pacemaker implantation and their influence on the scar

Abstract

Objective: There are two most common incisions that are used during most pacemaker implantation procedures, with the first type of incision being inferior and parallel to the clavicle (Group C) and the second type of incision along the deltopectoral groove (Group D). We evaluated the scars resulting from the two types of incision to objectively evaluate the degree of superiority in cosmetic outcomes, between these two types of incisions. Methods: Seventy-six patients who underwent left pre-pectoral pacemaker insertion were evaluated, close to 6 months after the date of the pacemaker implantation, using a simple scoring system based on atrophy, contour and colour of the scar. The likelihood of reduced severity in scar scores were compared between the two groups and the number of patients with elevation or inversion of the scar and with keloid formation were quantified. Results: Seventy-six patients, with 47 belonging to the ‘Group C’ and 29 belonging to the ‘Group D’ were evaluated. The average length (C: 25 ± 2 mm; D: 24 ± 3 mm) and thickness (C: 25 ± 3 mm; D: 26 ± 2 mm) of the scars were not significantly different. The mean cumulative total scores in ‘Group C’ (1.98 ± 1.50) and ‘Group D’ (1.93 ± 1.31) were comparable. The odds ratio (OR) estimate showed that outcomes for atrophy (OR:0.73), contour (OR:0.53) and the cumulative total scores (OR:0.72) were also comparable. Conclusion: This pilot study showed that the deltopectoral groove incision as a site of incision is comparable to the infraclavicular incision. Keywords: Bradyarrhythmia, Surgical scar, Cardiac implantable electronic devices