Consider the following medical report that includes the patient's historical health records. Use it to predict the disease that the patient is high likely exposed to. 

 Medical Report: allergies: captopril attending: chief complaint: tranfser for lead revision major surgical or invasive procedure: concerto pacemaker/defibrillator placement history of present illness: patient is a 66 y/o m w/ a h/o ischemic cardiomyopathy s/p cabg, atrial fibrillation on coumadin, prior vt ablation with biv pacer/icd who had nearly 20 episodes of his icd discharging yesterday. reports that he was going to bed at which time he felt light headed. at that point, his aicd fired several times, and then continuosly. he then activated 911 and was brought to hospital. . at the osh, ecg showed complete heart block with occasional second pauses with no capturing of his device. was shortly transcutaneously paced before patient's device was changed to lv pacing by a representative (doo). patient's device was interrogated and findings were interpreted as a possible lead fracture rather than true vt. reportedly device discharged 28 separate times. he has a fidelis lead which is known to be at risk for fracture and has been recalled. initial plan was for the patient to have a temporary wire placed, but lv pacing functioning well. patient was reportedly tolerating these settings well. tranfser was arranged to for lead extraction and revision. . on arrival in the ccu, initial vs were t98.7, hr 61, bp 104/83, rr 15, 94% ra. patient denied any complaints. . cardiac review of systems is notable for mild decrease in exercise tolerance. had previously been able to walk several miles w/o interruption, but in recent months he reports he has only been able to walk a few hundred feet before feeling short of breath. he denies chest pain, paroxysmal nocturnal dyspnea, orthopnea, increased ankle edema, palpitations. he reports his dry weight as 185 lbs, and recently has been taking increased doses of lasix, coreg and dig as per dr. . past medical history: -severe dilated ischemic cardiomyopathy (lvef less than 20%) -pacemaker/icd in , but upgraded in to biventricular/icd -extensive cad, with prior mis in , , and -cabg in -coronary stenting in revealed occluded svg to l-pda and stented left dominant circumflex -status post icd and pacemaker implantation following ablation of vt, resulting in complete heart block -hypertension -chf -moderate mitral regurgitation -paroxysmal atrial fibrillation (on coumadin) -bilateral carotid endarterectomies social history: married with three adult children and one six year-old. entertainer, plays guitar for the elderly. -denies smoking or using recreational drugs. he occasionally enjoys alcoholic beverages. family history: mother had htn and suffered cva. father died following second mi. brothers with htn. physical exam: gen: wdwn middle aged male in nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp of 10 cm. cv: soft systolic ejection murmur at apex chest: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abd: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. ext: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. . pulses: right: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ pertinent results: admission labs: 08:13am blood wbc-6.7 rbc-4.26* hgb-14.0 hct-40.0 mcv-94 mch-32.9* mchc-35.1* rdw-14.0 plt ct-162 08:13am blood neuts-83.0* lymphs-11.9* monos-4.3 eos-0.4 baso-0.4 08:13am blood pt-21.5* ptt-31.1 inr(pt)-2.0* 08:13am blood glucose-105 urean-23* creat-1.1 na-138 k-4.4 cl-101 hco3-31 angap-10 08:13am blood calcium-9.1 phos-3.6 mg-2.5 08:13am blood digoxin-0.5* . chest x-ray (): four transvenous leads running from the left power pack are unchanged since . two are pacer leads ending in the right atrium and alongside the left ventricle respectively, and two are defibrillator leads ending in the right ventricle. no discontinuity is visible in any lead. moderate cardiomegaly is not significantly changed from prior. the pulmonary vasculature is normal. increased density at the right lung base be either consolidation or summation of soft tissue. no pneumothorax or pleural effusion is present. impression: 1. no evidence of volume overload or acute cardiac decompensation. 2. possible right basal pneumonia or atelectasis, more likely overlyting soft tissue. . chest x-ray (): in comparison with the study of , the degree of pulmonary vascular congestion is somewhat decreased. continued substantial enlargement of the cardiac silhouette. no definite change in appearance of the various leads. . discharge labs: 07:10am blood wbc-5.6 rbc-3.68* hgb-12.1* hct-34.6* mcv-94 mch-32.8* mchc-34.8 rdw-13.7 plt ct-125* 07:10am blood pt-16.9* ptt-31.7 inr(pt)-1.5* 07:10am blood glucose-121* urean-23* creat-1.2 na-139 k-3.6 cl-99 hco3-33* angap-11 07:10am blood calcium-8.7 phos-2.8 mg-2.3 12:02am blood digoxin-0.5* brief hospital course: assessment and plan, as reviewed and discussed in multidisciplinary rounds patient is a 66 y/o m w/ ischemic cm, prior cabg, s/p biv pacer/icd placement, and h/o vt s/p ablation who presents with rv lead fracture, resulting inappropriate discharge of icd, and underlying complete heart block now dependent on lv lead for pacing. . #. lead fracture/heart block: received new pacer/icd but required vitamin k and platelets to reverse inr before procedure. on , patient had multiple episodes of asymptomatic nsvt with spontaneous termination and no icd firing. this subsequently resolved without intervention and he had no further episodes while inpatient. cxr confirmed lead placement and coumadin was restarted. he was continued on vancomycin peri-operatively then discharged on oral antibiotics. he will f/u in device clinic 1 week . #. chronic systolic heart failure w/o acute exacerbation/dilated ischemic cardiomyopathy: class iii heart failure by symptoms. he was continued on digoxin, lasix and valsartan. . #. cad: he was continued on aspirin, simvastatin . #. afib: rate controlled with complete heart block and pacer dependent. inr reversed with vitamin k and ffp then restarted at discharge . #. htn: well-controlled on carvedilol, diovan medications on admission: carvedilol 12.5 mg (recently increased) digoxin 0.125mg daily (recently increased) furosemide 80mg potassium 20 meq daily simvastatin 40mg daily diovan 40mg daily coumadin 6mg daily aspirin 81mg daily discharge medications: 1. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 2. digoxin 125 mcg tablet sig: one (1) tablet po daily (daily). 3. carvedilol 12.5 mg tablet sig: one (1) tablet po bid (2 times a day). 4. aspirin 81 mg tablet, chewable sig: two (2) tablet, chewable po daily (daily). 5. acetaminophen 500 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain. 6. furosemide 80 mg tablet sig: one (1) tablet po bid (2 times a day). 7. warfarin 2 mg tablet sig: three (3) tablet po once daily at 4 pm. 8. valsartan 40 mg tablet sig: one (1) tablet po hs (at bedtime). 9. potassium chloride 10 meq tab sust.rel. particle/crystal sig: two (2) tab sust.rel. particle/crystal po once a day. 10. cephalexin 500 mg capsule sig: one (1) capsule po three times a day for 7 days. disp:*21 capsule(s)* refills:*0* 11. outpatient lab work please check your inr on friday , call results to dr. at discharge disposition: home discharge diagnosis: pacer lead fracture chronic systolic congestive heart failure: ef 25% coronary artery disease paroxysmal atrial fibrillation on coumadin discharge condition: stable. afebrile discharge instructions: you had a broken lead on your icd that caused it to fire inappropriately. a new pacer/ icd was placed without complications. you will need to take antibiotics for one week to prevent infections at the pacer site. no baths or pools for one week. no lifting your left arm over your head for 6 weeks. you may brush your hair and your teeth. your coumadin level was reversed with vitamin k for the procedure. we restarted your coumadin but it might take some time to get your inr >2.0. please restart all of your home medications as before. medication changes: 1. cephalexin 500mg three times a day for one week. . weigh yourself every morning, md if weight > 3 lbs in 1 day or 6 pounds in 3 days. adhere to 2 gm sodium diet fluid restriction: followup instructions: device clinic phone: date/time: 10:00 . cardiology: provider: . phone: date/time: 2:00 procedure: implantation of cardiac resynchronization defibrillator, total system [crt-d] diagnoses: congestive heart failure, unspecified atrial fibrillation aortocoronary bypass status paroxysmal ventricular tachycardia other specified forms of chronic ischemic heart disease atrioventricular block, complete mechanical complication of automatic implantable cardiac defibrillator chronic systolic heart failure long-term (current) use of anticoagulants surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation 

Answer: The patient is high likely exposed to