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Does an infected pacemaker lead need to be removed?

Q: My 84 years old father had a pacemaker fitted on the right side, but it got infected and removed from right side and a new pacemaker fitted on the left side. But the lead of the older one remained there because of the difficulty in pulling it out. Now this lead/thread got infected due to which patient is having fever from three months. Is any laser surgery or new technique available to get rid of infected lead?

A:I am afraid, once a foreign material or a prosthesis gets infected, more often than not, it is impossible to cure it with antibiotics and the prosthesis has to be ex-planted or taken out. As you said, the pacemaker has already been taken out but the lead is still present on the right side and if it is infected, then it has to come out. The standard procedure is to apply gentle traction and to see if the lead works loose at the apex of the heart and comes out easily or not. If it doesn't, then I am afraid, one has to resort to an open heart surgical procedure, where the lead is taken out through the upper chamber of the heart using the heart lung machine. To my best of knowledge, there is no laser surgery available for it. However, to give more definitive opinion on this, you need to come for direct consultation and only after seeing the patient, can a definitive answer be given on this issue.

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