TY - JOUR
AU - Klaus, Alexander
AB -  Additionally, in our pediatric pacemaker population, we always chose the submuscular placement of the pulse generator^ and during a period of more than 10 years we were never confronted with pocket-related problems. In ICD implantations, all complications are serious and potentially lethal. Furthermore, they are very expensive, especially if one has to remove infected hardware and closely monitor the patient until a second, delayed procedure is possible with a new implant. Recently, a new and very small ICD was introduced for clinical use (Medtronic GEM DR II, Model 7273, Medtronic Inc., Minneapolis, MN, USA). Even this small device (39.5 cc, 77 g) we plan to routinely implant submuscularly in order to prevent the most serious complications: skin erosion, device extrusion, and subsequent hardware infection. The famous political economist John Maynard Keynes (t 1946) once said, "When the fact changes, I change my mind." At this time, ICD size is still too large for harmless subcutaneous implantation, and therefore it is yet not justified to recommend this technique. Perhaps, in the near future we can recommend the subcutaneous approach as the ICD size drops further. Herwig Antretter, M.D AlexanderfKlaus, M.D. Division of Cardiac Surgery, Dept. of Surgery University of 
TI - LETTERS TO THE EDITOR
JO - Pacing and Clinical Electrophysiology
DO - 10.1111/j.1540-8159.1999.tb00617.x
DA - 1999-08-01
UR - https://www.deepdyve.com/lp/wiley/letters-to-the-editor-UlOTh9HbC9
SP - 1274
VL - 22
IS - 8
DP - DeepDyve
ER -