Pacemaker -ICD battery and leads;
Your pacemaker system consists of a battery and cables placed in your heart to regulate your heart rhythm. The battery is 4-5 cm in size, connected with cables under the skin and fixed to your subcutaneous tissue with a stitch. The battery communicates with your heart through the cables (leads) connected to it. It makes the necessary corrections by giving the electrical stimulation your heart needs through pre-installed programs. After the cables are placed, they are stitched to the tissues to keep them stable. The cables have a screw or fringe-shaped system at their ends in order to remain stable within the heart.
Infection in the pacemaker pocket or at the cable ends;
Redness, discharge, fever, wound opening in the area where the pacemaker battery is placed, or if the skin is opened so that the battery or cables are visible from the outside. infection is mentioned. Pacemaker-associated infection is a vital condition and carries a risk of death between 6-35%. If the infection in the pacemaker pocket enters the blood, sepsis develops. In case of sepsis development and inflammation of the heart walls called infective endocarditis, the mortality rate is between 25-29%. Therefore, if infection is detected in the pacemaker pocket, the pacemaker battery and its cables must be removed.
How is PERCUTANEOUS LEAD EXTRACTION done?
The pocket placed for the removal of the pacemaker battery is anesthetized with local anesthesia. The pacemaker pocket is then folded open to access the battery. The battery is separated from where it is fixed to the skin. The connection between the battery and the cables is resolved with the help of a switch. Afterwards, the adhesions where the cables enter the vein are removed. Then, there is a channel inside the cables through which the guide wires can enter. The guide wire is advanced into this channel and the inner part of the cable is checked. If the inner part of the cable is solid, an extender wire is attached to the back of the cable. With the help of this extender wire, the battery cable is placed in a sheath with a trimming system at the end. The shaving blades in this sheath operate with a gun-like trigger system. It works with emi. When the shaving blades are delivered to the place where the cables are attached, the trigger is pressed and the blades rotate, cutting the adhesion tissue that has formed between the battery cable and the core. The adhesion area of the cables is usually the first part of the large vein through which the cable passes. In cables that were inserted a long time ago, adhesions may extend to parts close to the heart and be more rigid. When the adhesions in the places where the cables are stuck to the vein are removed, the attached part inside the heart is cut with the same knife system, the cable is released from the heart and the cable is taken out of the body.
In addition to removing the battery cables from the skin route, it is also possible to remove them surgically. The surgical method requires chest opening and general anesthesia. Therefore, it is a high-risk operation. Therefore, when removing the battery and cables, first try to remove it through the skin.
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