Doctors at a hospital in Kolkata have successfully treated a 76-year-old male patient from Patna in Bihar, who had been battling a recurring pacemaker-related infection for nearly a decade, caused by incomplete lead removal.
The complex case was treated at Manipal Hospital at EM Bypass by Dr Dilip Kumar, director – Cath Lab, senior interventional cardiologist, device and structural heart expert.
The patient got a pacemaker first implanted on the right side of his chest in 2015 at a local hospital in Patna. In 2018, the pacemaker was taken out and re-implanted on the left side but the initial lead that remained from the right-side implantation was not entirely removed.
Instead, it was severed and left within, which resulted in a subacute infection that gradually worsened. Though another surgery was undertaken in 2021-22, the problem could not be fixed, and the patient started developing persistent high-grade fever that lasted for more than three months.
While explaining the case, Dr Kumar, shared, ” Cardiac implantable electronic devices (CIEDs) revolutionised the management of heart rhythm disorders, but upon infection, particularly with incomplete lead removal, the consequences are life-threatening. In the case of Bipin Poddar, the embedded lead had formed a chronic infectious tract for almost 10 years. Clear extraction was necessary but extremely challenging given previous surgical scarring and the potential for further complications.”
He added, “Our team had to plan the procedure with utmost accuracy to remove the infected lead completely without jeopardising the patient`s heart function. In such situations, leadless pacemakers (LPs) have proven to be a better, safer option compared to conventional devices, particularly when used in conjunction with transvenous lead extraction (TLE). Data on both simultaneous LP implantation and TLE, especially in pacemaker-dependent patients within the Indian context, is limited. This case adds strength to the increasing importance of advanced methods in complicated cardiac infections.”
After a proper procedure, the contaminated lead was removed entirely, and the infection was effectively controlled. The patient was discharged in good condition after recovery.
Describing his experience, Bipin Poddar reacted, “I was suffering for years with intermittent fever and weakness. Although I had undergone several surgeries in Patna, the core of the issue had never been tackled. Everything was different once I came to Manipal Hospital EM Bypass. Not only did Dr. Dilip Kumar and his staff correctly identify the problem, but they treated me with so much care and professionalism. I feel like I have been reborn.”