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Thai) 1:
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VVIR permanent pacemaker reportprocedure :single chamber rate -responsive pacemaker implantation (VVIR)preoperation diagnosis: CHBMedications: Cefazolin 1 gm IV ,2% lidocaineDescription of the procedure After the infored consent was obtained ,the pateint was brought to the cardiac catheterization in the postobsortive, unsedated state . the anterior chest wall was preped and draped in the usual sterile technique . local anesthesia was achieved with 2% lidocaine infiltration. A scalpel was used to create sharp dissection at a level 3 cm .inferior to the left clavicle which extended horizontally across deltopectoral groove.the incision was extended to the pre-pectoral fascia with additional sharp and blunt dissection.right ventricle lead pacing threshold, sensing and lead impedance parameters were evaluated with the pacing system analyzer (PSA)and found to be satisfactory .the lead was secured tothe fascia and fixed to the myocardium (apex)-Screw 12 rounds. the lead was inserted into the generator connector block, andsecured osing the supplied allen wrench . traction was provided on the lead to encure attachment .using blunt dissection,a subcutaneous pocket was created for the pulse for the pulse generator was inserted into the pocket ensuring that the lead was positioned beneath or around the pulse generator and fixed the generator with silk No 20. it was ensured that the pocket was not overly tight. then,attention was directed toward closure of the wound . the pocket was cleaned with diluted betadine solution .the fascia and subcutaneous layers were closed with 3-0 chromic cutgut in interrupted stiches.the skin was closed with 3-0 Dermalonin interrupted stitches.medtronic relia model resr01 (SN:NWU070436G) medtronic 5076 -58 cm (SN:PJN376565G) R wave 7.1 mV, VOLTAGE Threshold 0.5 V@0.5ms, Impedance 952 ohms setting:VVIR 60-120 bpm, Output 3.5 V@0.4ms,SENSE 2.8 mVConclusion :Successful single chamber pacemaker implantation.plan:observe ,12 lead EKG,follow-up CXR
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