Explantation of permanent pacemakers

    Authors

    Keywords

    pacemaker explantation, lead extraction, patient preparation, nursing care, infection management

    DOI

    https://doi.org/10.15836/ccar2025.296

    Full Text

    Explantation of a permanent pacemaker is a complex procedure that requires careful multidisciplinary planning to minimize complications and ensure patient safety. Indications for device removal include infection at the pocket site, systemic infection such as endocarditis, lead malfunction, device recall, or erosion of the device through the skin (1). Pre-procedural preparation involves thorough clinical and laboratory evaluation, optimization of anticoagulant and antiplatelet therapy, and exclusion of uncontrolled infections. Patients must be adequately informed and provide written consent, while preoperative measures typically include pre-procedural fasting, hair removal at the surgical site, and the establishment of reliable intravenous access. Strict aseptic conditions and perioperative antibiotic prophylaxis are essential to reduce the risk of reinfection. Depending on the complexity of the case, explantation may be performed via simple pocket revision, transvenous lead extraction, or surgical removal. Nursing care plays a key role in patient education, psychological support, intraoperative monitoring, and coordination of postoperative care, including wound management and follow-up. Standardized protocols based on international guidelines improve procedural success rates, reduce morbidity, and contribute to improved long-term patient outcomes.

    Literature

    1. Döring M, Richter S, Hindricks G. The Diagnosis and Treatment of Pacemaker-Associated Infection. Dtsch Arztebl Int. 2018 June 29;115(26):445–52. https://doi.org/10.3238/arztebl.2018.0445
    Cardiologia Croatica
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    Explantation of permanent pacemakers

    Extended Abstract
    Issue11-12
    Published
    Pages296
    PDF via DOIhttps://doi.org/10.15836/ccar2025.296
    pacemaker explantation
    lead extraction
    patient preparation
    nursing care
    infection management

    Authors

    Iva Petković*ORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Dubravka MilačaORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia

    *Correspondence email: iva.petkovic1234@gmail.com

    Full Text

    Explantation of a permanent pacemaker is a complex procedure that requires careful multidisciplinary planning to minimize complications and ensure patient safety. Indications for device removal include infection at the pocket site, systemic infection such as endocarditis, lead malfunction, device recall, or erosion of the device through the skin (1). Pre-procedural preparation involves thorough clinical and laboratory evaluation, optimization of anticoagulant and antiplatelet therapy, and exclusion of uncontrolled infections. Patients must be adequately informed and provide written consent, while preoperative measures typically include pre-procedural fasting, hair removal at the surgical site, and the establishment of reliable intravenous access. Strict aseptic conditions and perioperative antibiotic prophylaxis are essential to reduce the risk of reinfection. Depending on the complexity of the case, explantation may be performed via simple pocket revision, transvenous lead extraction, or surgical removal.

    Nursing care plays a key role in patient education, psychological support, intraoperative monitoring, and coordination of postoperative care, including wound management and follow-up. Standardized protocols based on international guidelines improve procedural success rates, reduce morbidity, and contribute to improved long-term patient outcomes.

    Literature

    1. 1.
      Döring M, Richter S, Hindricks G. The Diagnosis and Treatment of Pacemaker-Associated Infection. Dtsch Arztebl Int. 2018 June 29;115(26):445–52.DOI