District witnesses first lead extraction surgery

Coimbatore: Kovai Medical Center and Hospital (KMCH) has extracted a lead wire of pacemaker that was implanted in a 50-year-old woman without opening the heart. The procedure that was considered risky, was done for the first time in the district, the hospital said.
“The patient, who had implanted pacemaker device for sick sinus syndrome over two years ago, was admitted to the hospital after she was diagnosed with infection. While the battery of the pacemaker was changed at another hospital, she had approached the hospital to remove the lead wire attached to the heart,” said Dr Lawrance Jesuraj, electrophysiologist and interventional cardiologist, who performed the extraction.

The wire delivers energy from 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, the doctor said, explaining that there are chances of perforating the heart while removing the wire. “It would result in major bleeding. In some cases, it requires blood transfusion or immediate open heart surgery to save the patient. As manual extraction was not possible, we removed the lead using lead locking device within 45 minutes. It was done under local anaesthesia and conscious sedation in the presence of heart surgeon,” Jesuraj explained.

“As per the international standard, only 1-2% of infection is allowed during pacemaker surgeries. But there are instances of 7% infection. As they are life-threatening, infections need to be cured immediately by removing the lead. The number of such instances are increasing in the country off late. The country hardly has 10 hospitals that performs lead extraction,” he added.