Pacemaker infection

• by Wm
• 2020-02-18 13:24:09
• Complications
• 1020 views
• 2 comments

I am writing this account of a pacemaker infection as a patient because they are rare and because there may not be a written account from a patient, in the hope it may help in the understanding and treatment of the problem.

I am a 73 year single old male who had a myocardial infarction 15 years ago with angioplasty and two coated stents. Last November 7 I came down with what I thought was a bad case of ‘flu which lasted for three weeks. On a Saturday evening I went to the hospital where I was told I had a complete heart block and needed a pacemaker. Sunday was spent waiting for my regular heart medication to dissipate and Monday the pacemaker was implanted. That evening I was doing fine, up and walking the halls expecting to be sent home Tuesday.

First outbreak:

Monday night after receiving the implant I woke briefly feeling some heat and pain in my chest. Tuesday morning I woke feeling a great deal of heat and pain in my chest with painful, difficult breathing. Each time my lungs tried to expand they created pain. I was given an antibiotic (vancomycin) intravenously which removed the heat and pain. Blood tests were done before and after the antibiotic. I was kept in the hospital for couple of days to make sure the infection was gone and discharged on Friday (6 December). I was released with an ejection fraction estimated by ultrasound at 40.

Second outbreak:

A month later on 10 January I woke with a great deal of heat and pain in my neck on the same side as the pacemaker. I was also very weak. It was not affecting any major body function so I waited to see if it would go away on its own. Up to this point recovery from the surgery had been progressing and I set myself some new goal every couple of days to test my strength. That strategy was now changed to complete bed rest. Each day the heat and pain were less. On the third day I tried chewing gum to exercise the jaw which was stiff making it difficult to eat. The chewing gum helped a lot. The infection was in the neck and throat so I tried gargling with salt and soda solution but do not know if that helped. After two weeks there was no longer any pain, swelling, or stiffness. However the weakness persisted.

Third outbreak:

A month later on 4 February I had developed an aching pain in my shoulder and neck on the same side as the pacemaker. The pain was strongest at the tip of the shoulder blade. It had got too painful to sleep. I got the idea of putting ice on it, slipping a small ice pack from the refrigerator down the back of my top and lying back on the bed to hold it in place. I was able to sleep. In the morning the pain under the ice pack was gone. I also hoped the cold would kill the infection. All the pain was gone by 12 Feb. The weakness persisted. The outbreaks of infection have set back recovery from the pacemaker implant.

Source of infection?

I cannot remember my armpits being sterilized.  As I recall the patient is strapped down with arms at sides before the chest is sterilized. The chest was draped but I do not know the length of the drape. The doctor had to use a lot of force to implant the pacemaker and judging by the bruises may have inserted his fingers into the armpit for leverage.  That would be a possible source of contamination.