Coimbatore hospital performs lead extraction procedure
Nivedha Selvam | TNN | Mar 1, 2019, 18:10 IST
COIMBATORE: Kovai Medical Center and Hospital (KMCH) has extracted a lead wire from pacemaker that was implanted in a 50-year-old woman without opening her heart. The extraction, which is considered risky, was done for the first time in Coimbatore.
“The patient, who had implanted the pacemaker for sick sinus syndrome over two years ago, was admitted to hospital after she was diagnosed with infection. While the battery of the pacemaker was changed in some other hospital, she had approached the hospital to remove the lead wire which is attached to the heart,” said electrophysiologist and interventional cardiologist Dr Lawrance Jesuraj, who performed the extraction. The wire delivers energy from a pacemaker to the heart muscle.
While the device is attached under the skin, the lead wire would be attached to the scar tissue of the heart. As years pass, it becomes difficult to separate the wire from the heart, he said, explaining that there are chances perforating the heart while pulling the wire with force.
Perforating the heart would result in major bleeding in the chest or around the heart and in some cases, it requires blood transfusion or immediate open heart surgery to save the patient.
“As manual extraction was not possible, we have removed the lead with a device called lead locking device within 45 minutes. It was done under local anesthesia and conscious sedation. It was performed in the presence of heart surgeon to deal the situation in case of any complications,” he explained.
He said that as per the international standard only 1% to 2% of infection is allowed where doing pacemaker surgeries, but there are instances where more than 7% of infection is done during the surgery. As it life threatening, infections need to be cured immediately by removing the lead.
Explaining that the number of such instances are increasing in the country of late, he said that the country hardly has ten hospitals or centres which perform lead extraction. There are separate centres which excel in the field in foreign countries.
“The patient, who had implanted the pacemaker for sick sinus syndrome over two years ago, was admitted to hospital after she was diagnosed with infection. While the battery of the pacemaker was changed in some other hospital, she had approached the hospital to remove the lead wire which is attached to the heart,” said electrophysiologist and interventional cardiologist Dr Lawrance Jesuraj, who performed the extraction. The wire delivers energy from a pacemaker to the heart muscle.
While the device is attached under the skin, the lead wire would be attached to the scar tissue of the heart. As years pass, it becomes difficult to separate the wire from the heart, he said, explaining that there are chances perforating the heart while pulling the wire with force.
Perforating the heart would result in major bleeding in the chest or around the heart and in some cases, it requires blood transfusion or immediate open heart surgery to save the patient.
“As manual extraction was not possible, we have removed the lead with a device called lead locking device within 45 minutes. It was done under local anesthesia and conscious sedation. It was performed in the presence of heart surgeon to deal the situation in case of any complications,” he explained.
He said that as per the international standard only 1% to 2% of infection is allowed where doing pacemaker surgeries, but there are instances where more than 7% of infection is done during the surgery. As it life threatening, infections need to be cured immediately by removing the lead.
Explaining that the number of such instances are increasing in the country of late, he said that the country hardly has ten hospitals or centres which perform lead extraction. There are separate centres which excel in the field in foreign countries.
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