A totally extruded pacemaker

Total extrusion of a pacemaker generator is an extremely rare and potentially fatal complication of pacemaker implantation. An 82-yearold female patient was brought to our out-patient clinic by relatives who had noticed that the device was outside of her body. The pulse generator and proximal portions of both leads had been expelled from the anterior axillary region. There was no sign of active purulent inflammation, and granulomatous tissue surrounded the exit site (Fig. A). Examination of the device revealed acceptable sensing, pacing and impedance measurements in VVI mode.