• Journal of Chest Surgery
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• v.35 no.11
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• pp.831-834
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• 2002

When any part of the pacemaker system is infected, all pacemaker hardware should be removed, because reinfection rates of 51% to 77% have been noted in patients whose infected pacemaker system has been only partially explanted. The removal of infected leads during cardiopulmonary bypass prevents mechanical injury as well as the spread of infection and vegetation. We report one case of endocarditis by staphylococcus aureus with infected transvenous pacing lead which was migrated into the heart from the left subclavian vein. We removed the migrated pacing lead and vegetation under cardiopulmonary bypass.

• Journal of Chest Surgery
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• v.36 no.10
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• pp.780-783
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• 2003

Pacemaker lead-related infective endocarditis is an uncommon, but serious complication. We report a case of a 45-year-old man who had symptom of intermittent high fever and rupture of sinus Valsalva that developed after a redo aortic valve replacement and transvenous permanent pacemaker implantation. Positive blood cultures of streptococcus viridans and transesophageal echocardiography showing a large mobile vegetation on pacemaker lead and tricuspid valve lead to the diagnosis of pacemaker lead-related infective endocarditis. Initial antibiotic therapy followed by surgical extraction of the pacemaker lead and wide debridement of infective tissues including multiple vegetations was required. Postoperative antibiotic therapy was continued for 4 weeks. The postoperative course has been uneventful. The patient is totally asymptomatic and is doing well up to now.

• Transactions of the Korean Society of Mechanical Engineers B
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• v.35 no.11
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• pp.1205-1211
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• 2011

In this paper, we developed a pacemaker that can increase the efficacy of a left ventricular assist device (LVAD) and increase the survival rate for patients suffering end-stage heart failure. Because LVAD patients can experience arrhythmia, the pacemaker incorporated into the LVAD has the important role of sustaining sufficient blood circulation during arrhythmia. The electrode of the pacemaker is located at the apex of the left ventricle, where the VAD's inlet cannula is connected. This is efficient placement, in that the electrode can transmit electrical stimulation directly to the Purkinje fibers of the myocardium. The pacemaker can change the stimulation rate from 0 bpm to 191.4 bpm when a button is pressed on the external control module, and the pacemaker normally stimulates the heart at 60 bpm with 0.25 J of energy. We performed animal experiments to evaluate the performance and reliability of the combination of the LVAD and pacemaker. At pacemaker stimulation rates of 86.4 bpm, 100.2 bpm, 126.6 bpm, we recorded the ECGs, aortic pressures, and flow rates to analyze the heart loads.