Pacemaker op is first for Scott County

December 22, 2005

By PAUL ROY
Independent Herald Publisher

A history-making surgical procedure was performed Monday afternoon at the Scott County Hospital, when a woman in her 70s had a pacemaker implanted to control her heartbeat.

Farrell Pierson, M.D., a cardiologist with West Knoxville Heart, PC, who also works out of a local physician’s office, performed the 30-minute surgery with the assistance of Scott County Hospital surgical staff who had trained with Dr. Pierson at Knoxville’s Park West Medical Center.

Monday afternoon’s surgery was actually to remove an existing pacemaker and install a new one to electronic leads already connected to the heart. The procedure was done to correct a slow heartbeat, Dr. Pierson said.

The pacemaker, a small metal device about the size and twice the thickness of a silver dollar and powered by a Lithium battery, is in reality a “small, sophisticated computer,” according to Dr. Pierson, who said it could be programmed “to do what we want it to do.”

Although new to the surgical suite at Scott County Hospital, Dr. Pierson said that pacemaker implantation procedures are very common across the country, with anywhere from 20,000 to 30,000 being done each year. Dr. Pierson, himself, has performed more than 500 such procedures over the last several years.

Dr. Pierson, who shares office space with Dr. Larry Perry in Northtown Plaza, said he has several local patients he has been seeing here over the past seven years. In fact, he was the surgeon who did the original pacemaker implantation (in 2000 at Park West) on the woman he operated on Monday. The second implantation procedure, he said, was required because “the battery had run down” and the device needed to be replaced.

Another pacemaker implantation surgery has been scheduled at Scott County Hospital on January 2, Dr. Pierson said.

Dr. Pierson, while not on the staff of the local hospital, has had consulting privileges and been seeing patients at Scott County Hospital since 1998.

The reason the surgery was performed here instead of Park West is because “there’s a segment of the population here that has a difficult time making it down to Knoxville and we’d like to make the services available to them here without having them to drive all the way to Knoxville,” Dr. Pierson said.

The procedure is relatively a simple one, as a small incision is made in the upper portion of the chest near the shoulder and the pacemaker is inserted “just below the skin,” he explained.

Dr. Pierson said there is a large vein under the collarbone in which one or two leads are implanted leading directly from the pacemaker to the heart.

“It’s done under fluoroscopic guidance under local anesthetic. In general, the procedure only takes 30 to 45 minutes,” he stated. “It’s a very, very common procedure anymore.”

Dr. Pierson said that the surgical unit and Scott County Hospital’s surgical staff are well suited to performing pacemaker implants, due in part to it being “a very, very low risk procedure . . . maybe in the range of one to two percent complication rate and most of those can be handled right here at the hospital. It would be a very rare circumstance that the patient would have to be transferred elsewhere for complications.”

By the same token, Dr. Pierson said that he doubted that implantation procedures would be scheduled here for “any of the more sophisticated devices like defibrillators—those are a little higher risk of complications and not something that I think we could handle all contingencies here.” Such complications, should they occur, would require the assistance of a heart surgeon for emergency heart surgery, “and we don’t really have any heart surgeons in this area,” Dr. Pierson explained.

A native of southeast Arkansas, Dr. Pierson earned his medical degree at the University of Arkansas.

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