Intrathoracic surgery for retained endocardial electrodes was performed in 12 patients;
the indication for electrode removal was Staphylococcus aureus or epidermidis infection
in 11 patients and malfunction in one patient. Two operations had to be performed
on emergency basis. One was carried out because of myocardial rupture and cardiac
tamponade after a tightly fixed electrode lead had been pulled out. The other patient
was operated on because of ventricular arrhythmia arising from a malfunctioning lead
which had slipped back completely after transsection into the right ventricle. Ten
patients underwent elective surgery; cardiopulmonary bypass was needed in 6 of these.
In one case a mitral prosthesis was replaced because of infection. Radical treatment
is recommended for pacemaker infections and the removal of electrodes should be considered
even if intrathoracic surgery is required.
Pacemaker - Electrode complications
