the improvement of the atrial flutter rhythm upon the removal of the infected permanent pacemaker lead

pacemaker infection has multiple risk factors. its presentation is most often similar to infected endocarditis and the diagnosis is made through studying blood cultures. transesophageal echocardiography can confirm the diagnosis. the most common microorganisms are staphylococcus speciesis. as a matter of fact, complete pacemaker removal appears to be the only definite treatment. we presented a case of infected pacemaker lead which was firstly referred with fever and nephritic syndrome. she had intermittent atrial flutterrhythm. therefore, a total infected pacemaker system was removed under cardiopulmonary bypass support. yet, the lead was firmly attached to the septal leaflet of tricuspid valve while leaflet repair was needed. as a result, atrial flutter rhythm was converted into sinus rhythm after an incidental interruption of the macroreentrant circuit in the process of the tricuspid leaflet surgery.