5th May 2025

Mr James has had a dual chamber pacemaker put in almost one week ago for complete heart block.

Mr James has had a dual chamber pacemaker put in almost one week ago for complete heart block. He has a previous medical history of ischaemic heart disease, stroke, atrial fibrillation and type 2 diabetes mellitus. His last HbA1c was 64mmol/mmol. He attends the ambulatory medical care unit with pain over the pacemaker insertion site. On examination, you notice he is afebrile and haemodynamically stable. His pacemaker site looks mildly erythematous and tender, but there is no discharge. ECG shows a paced rhythm. Blood tests show Hb 140, WCC 12.5 (neutrophilia), CRP 25 and eGFR >90. He has NKDA. What is the most appropriate step in his management?

Select the SINGLE most appropriate option from the list below. Select ONE option only.