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Case Reports
. 2011;6(1):35-7.
doi: 10.2185/jrm.6.35.

Entire removal of screw-in pacing leads 3 years after implantation

Yasuyuki Shimada  1
Affiliations
Case Reports

Entire removal of screw-in pacing leads 3 years after implantation

Yasuyuki Shimada. J Rural Med. 2011.

Abstract

Objective: To report that screw-in type pacing leads can be removed by screw retraction even after a significant anchoring period.

Patient: A 78-year-old woman who visited our hospital for skin erosion over a pacemaker that had been implanted 3 years previously and had migrated from the subclavicular area to the axilla.

Methods: Culture revealed a local staphylococcus infection. We placed a new pacemaker system in the contralateral (right) side, removed the old one, inserted a straight type stylet into the leads, and turned the rotator counterclockwise.

Results: An image monitor confirmed complete retraction of the ventricular lead screw and partial retraction of the atrial lead screw, and we were able to pull out both leads without any resistance. The patient was given antibiotics and discharged 2 days after the surgery. No wound infection was evident at a 3-month follow-up examination.

Conclusion: When a screw-in type pacemaker with a retractor must be removed long after its implantation, screw retraction should be tried before resorting to a removal kit or open heart surgery.

Keywords: infection; pacemaker; pacemaker lead.

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Figures

Figure 1
Figure 1
Chest x-ray taken 3 years ago (left) and on current admission. White arrows point to the generator, which migrated from the subclavicular area to the axilla.
Figure 2
Figure 2
The white arrow points to skin erosion over the generator at the axilla.
Figure 3
Figure 3
Ventricular (left) and atrial pacing leads after removal. The ventricular lead screw was completely retracted, but the final loop of the atrial lead screw remained in the body. Note the stretched screw and small amount of heart tissue on it.
See this image and copyright information in PMC

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References

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