Due to the miniaturization and rapid evolution of technology, CRMDs are currently mostly implanted subcutaneously in the subclavicular fossa using transvenous leads. The number of pacemakers, implantable cardioverter defibrillators (ICDs), and cardiac resynchronization therapy device implants now exceeds 1.5 million per year globally. The field of implantable cardiac rhythm management devices (CRMDs) has expanded rapidly over recent years. A simple exercise program aimed at strengthening the shoulder girdle is effective at preventing this complication. There were no activity-related complications in either group.Ĭonclusion: Shoulder pain and disability occurs often following cardiac rhythm management device implantation. Scores for the questionnaires designed to assess shoulder pain and dysfunction were worse in the control group. In the control group, five of 19 patients developed a positive impingement test at 1 month, versus none in the exercise group (P = 0.01). At 6 months, four of 23 control patients still reported worsening shoulder symptoms, compared to none in the exercise group (P = 0.11). At 1 month, seven of 21 control patients reported developing shoulder pain or discomfort compared to one of 23 in the exercise group (P = 0.02).
Groups were postoperatively monitored for the development of shoulder discomfort and shoulder impingement by using physical examination and disability questionnaires.
The control group received standard instructions, whereas the exercise group was instructed on specific exercises aimed at strengthening or stretching the shoulder girdle, to be completed 3 days per week. Methods and Results: Patients undergoing subcutaneous device implantation were randomized to one of two groups. We designed a study to assess the potential benefit of a simple exercise protocol in preventing shoulder pain postoperatively. Introduction: Shoulder pain and disability ipsilateral to the implant site is a common complication of cardiac rhythm device implantation, yet very little has been published about this morbidity.
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