Using laser technology, doctors of Apollo Hospitals performed an interventional procedure to remove the infected wires of a pacemaker from the heart of a 72-year-old man from Jharkhand.
A. M. Karthigesan, interventional cardiologist and electrophysiologist, Apollo Hospitals, said in 2015, the patient had received his first pacemaker on the right side as he had low heart rate. However, he developed a severe pocket infection and repeated wound cleaning did not help in healing. The pacemaker was partially removed but the wound did not heal, and a new pacemaker was implanted on the left side at another centre. At Apollo Hospitals, the patient presented with symptoms of severe pocket infection with abandoned leads in the heart.
Cardiac implantable electronic devices such as pacemakers are implanted in the shoulder region, and the wires link the machine and heart, he said, adding that there are chances of infection when such devices are implanted. Patients who are on steroids, dialysis and immunosuppressive agents are at risk for infection. He said 60% of infections develop within three months, and 40% after a year. Patients experienced swollen pockets and discharge from the wound.
“Once there is an infection, the foreign body should be removed. But removal is the challenge,” he said. Sometimes, after pacemaker implantation, the lead wires tend to stick to the cardiac tissues due to fibrotic adhesions or scars that develop as the body begins to recover, making extraction difficult. Failure to remove infected wires can aggravate the infection and cause life-threatening complications. “Open heart surgery is done or mechanical tools are used to remove the wires. In 2021, new laser technology for lead extraction was launched, and an advanced technology was launched six months ago,” he told reporters on Friday.
In this, a sheath is passed, and the tip of the sheath emits laser that vaporises the scar tissue that has formed around the cardiac leads, he said. Two wires were removed from the patient and the wound healed in a week after the procedure.
R.K. Venkatachalam, director of medical services, Apollo Hospitals was present.
