Our Nuts and Bolts in The Permanent Pacemakers’ Explanation Techniques

Objective: Our goal is to share our two decades of experience with implantable electrical device explanation at our electrophysiology centre at Hayat Abad Medical Complex in Peshawar. Methodology: After baseline patient were brought nil by mouth to catheterization laboratory (Cath: lab). A temporary pacemaker (TPM) implanted for backup.  In case of box change, a new device is attached after checking the integrity of the lead and device placed in the same pocket. But if of lead extraction was also needed, then stylet was put inside the lead and with twisting movement and mild traction the lead removed and new lead implanted with Seldinger,s technique, battery attached and wound closed in layers. Results:  Out of 1670, there were 1535 (91.9%) new implantations and 135 (8.08%) repeat procedures. The pulse generator was replaced without lead replacement in 59 (3.5%) patients. In 36 (2.15%) patients, the ventricular lead or atrial lead was successfully reposition. A total of 32 (1.9%) successful explanations were performed in the study period. Conclusion: The explanation of devices like implantation needs special gadgets and training for the safe and successful procedure.