1. Consult a local physician or the doctor under whose care he had been for his comorbidities and get a thorough clinical checkup done. 2. A urine routine and microscopic examination can be performed as UTI is d commonest subclinical infection to creep in such cases 3. Can get a fresh Echo cardio graphy done to know if there are any recent vegetation s or other signs of carditis which  often complicates post pacemaker status n congestive heart failure cases. consult your cardiologist for further opinion regarding the matter. 3. Maintain as much as practicable asepsis in and around the patient . 4. Get a renal function test , recent fasting and 2hour postprandial blood glucose level check done. 5. Maintain a temperature chart if he developes rise in temperature. 6. If possible monitor the urine output. 7. Donot self medicate specially wid antibiotics as they are often nephrotoxic and require proper dose adjustments for such pts.