Therapeutic Research

Abstract

Ninty–seven–year–old female was transferred to our hospital due to pacemaker pocket infection. She underwent dual –chamber pacemaker implantation for sinus node dysfunction 13 years prior and generator exchange 3 years prior. She complained of pacemaker generator exposure and redness of the skin. It was quite difficult for her to stay in our hospital for a long time with temporary pacing catheter after lead extraction due to being very elderly and severe dementia. Therefore, we planned to perform a percutaneous lead extraction and leadless pacemaker implantation at the same time, because two sets of blood culture tests were negative, and her infection was localized to the pacemaker implant site. She underwent general anesthesia, and the atrial and ventricular leads were successfully extracted with laser sheaths, rotational dilator sheaths, and snare. Following the lead extraction, a leadless pacemaker was implanted from the right femoral vein in the right ventricular apical septum. It is sometimes difficult to determine the timing of re–implantation after the removal of infected device because we must obtain balance between the necessity of implantation and curing infectious disease.