Document Detail


Appropriateness of sling immobilization to prevent lead displacement after pacemaker/implantable cardioverter-defibrillator implantation.
MedLine Citation:
PMID:  19169389     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
After pacemaker/implantable cardioverter-defibrillator (pacemaker/ICD) implantation, patients are often required to immobilize the affected arm with a sling to minimize the risk of lead displacement. We examined whether performing a resistive range-of-motion exercise protocol after pacemaker/ICD surgery would result in lead displacement and, therefore, whether sling immobilization and activity restrictions are justified. Ten subjects who had undergone pacemaker/ICD surgery performed four individual resistive range-of-motion exercises (three sets of 10 repetitions for each: one warm-up set without weight and two sets with a 1- or 2-pound hand weight) with the affected arm prior to hospital discharge. For each subject, an electrophysiology nurse specialist used a noninvasive device programmer to evaluate surgical lead placement before and after the exercises. As an adjunct to the study, we queried clinicians at 48 US hospitals about sling immobilization and activity restrictions after pacemaker/ICD implantation at their institutions. No lead displacement occurred after the weightlifting exercises were performed. Based on these results in a small group of patients, it appears that requiring the use of a joint immobilization sling is overly restrictive, promotes fear, and hinders recovery. We encourage the development of consistent discharge instructions that will promote early mobility and a safe and rapid return to normal activities.
Authors:
Aster Naffe; Mini Iype; Mini Easo; Sandra Dejong McLeroy; Kelli Pinaga; Nancy Vish; Kevin Wheelan; Jay Franklin; Jenny Adams
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Proceedings (Baylor University. Medical Center)     Volume:  22     ISSN:  0899-8280     ISO Abbreviation:  Proc (Bayl Univ Med Cent)     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9302033     Medline TA:  Proc (Bayl Univ Med Cent)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3-6     Citation Subset:  -    
Affiliation:
Baylor Jack and Jane Hamilton Heart and Vascular Hospital, Dallas, Texas.
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