A 76-year-old male patient from Patna, Bihar, who had been suffering from a recurrent pacemaker-related infection for almost ten years due to incomplete lead removal, was successfully treated by Manipal Hospital, EM Bypass, in a historic development in cardiac treatment. Dr. Dilip Kumar, Senior Interventional Cardiologist, Device and Structural Heart Expert, Director of Cath Lab, Manipal Hospital EM Bypass, provided professional care for the complicated case.

In 2015, Bipin Poddar, a businessman by trade, had a pacemaker initially placed on the right side of his chest at a Patna hospital. The pacemaker was removed and reinstalled on the left side in 2018; however, the original lead from the right-side implantation was left in place. Rather, it was chopped off and left inside, causing a subacute infection that grew worse over time. Despite undergoing another operation in 2021–2022, the issue remained unresolved, and the patient began to experience a high-grade fever that persisted for over three months.

Dr. Dilip Kumar said, “The treatment of heart rhythm abnormalities was transformed by cardiac implantable electronic devices (CIEDs); however, infections can be fatal, especially when lead removal is not thorough. For nearly ten years, the embedded lead in Bipin Poddar’s case had created a chronic infectious tract. Considering the possibility of additional difficulties and the scarring from prior surgery, a clear extraction was required but very difficult. To fully remove the contaminated lead without endangering the patient’s heart function, our team had to meticulously organize the treatment. When combined with transvenous lead extraction (TLE), leadless pacemakers (LPs) have shown themselves to be a safer and more effective alternative to traditional devices in certain circumstances. There is little information available on TLE with simultaneous LP implantation, particularly in pacemaker-dependent patients in India. This instance supports the growing significance of cutting-edge techniques in complex heart infections”.

Following the correct protocol, the illness was successfully managed, and the tainted lead was eliminated. After recovering, the patient was released in good health.

The state-of-the-art cardiac care and clinical expertise offered at Manipal Hospitals in the east region are demonstrated by this complex case.

Priyanka Dutta