Document NegzJyMMYndNZY2wMzovXNBN8

OHM 000309 DATE: 06/18/03 PHYSICIAN: JAMES D WATSON, MD Opts ACCOUNT NUMBER: 000021584900 DISCHARGE: \ \ J i \ r NAME OF OPERATION: PACEMAKER IMPLANTATION. SURGEON: JAMES WATSON, M.D. INDICATIONS: Mr. Smith is 75 years old with chronic atrial fibrillation with clear bradycardia and 9 second pauses on Hoiter. Patient now presents to the cardiac catheterization laboratory. DESCRIPTION OF OPERATION: Left subclavian area was prepped and draped in the usual sterile fashion. Lidocaine 1% was used to infiltrate the skin area, lidocaine with epinephrine. Decreased bleeding. Then 1% lidocaine was used to infiltrate the area of the needle puncture site. This was done using a micropuncture set followed by a sheath followed by 0.0035 wire. Sharp dissection was made down to the pectoralis muscle and blunt dissection was used to obtain a pacer pocket. The 0.0035 wire was then traversed out through the pacer pocket. A sheath was placed over the 0.0035 wire and a fine line ventricular lead was placed. A fineline two-mile #4471, serial #311812 in the tip of the right ventricle. Threshold is 0.3 volts. V wave 6.7 millivolts and 120 ohms. This was sutured in place on the pectoralis muscle. Two ligatures to hold the collar to the muscle and one ligature to hold the collar to the lead. No evidence of bleeding was seen whatsoever in the pocket and the pocket was irrigated with antibiotic solution. This was then connected up to the Guidant INSIGNIA 1194 pacemaker model, serial #110453. Low rate is 60, upper rate 130. SMITH, DEANE R 0000000000369197 OPERATIVE REPORT OVERLAKE HOSPITAL MEDICAL CENTER Page 1 of 2 I { j \ \ \ ! i ; ! ; J ] ' t ; : ; i. i j ; i , | ; t i OHM 000309 D-1070