Pacemaker lead infection: report of three cases and review of the literature.
Pacemaker lead infection is a rare condition, most often occurring when intervention is needed after pacemaker implantation. Diagnosis is by blood cultures and confirmation by transoesophageal echocardiography; transthoracic echocardiography is often inadequate. A literature review indicated the microorganism most responsible for late lead infection is Staphylococcus epidermidis (which can grow on plastic material). A retrospective analysis of patient files from the authors' institution (1993-97) yielded three patients with proven pacemaker lead endocarditis. The diagnosis of pacemaker endocarditis was by transoesophageal echocardiography. The endocarditis appeared after a long period and in two of the three patients there was S epidermidis infection. Thoracotomy with removal of the infected system was performed because of the large dimensions of the vegetations. A new pacemaker was implanted: in one patient with endocardial leads, in the other two with epicardial leads. All three patients recovered well and follow up was uneventful for at least one year.
Voet
J G
JG
Department of Cardiology, AZ Sint-Jan, Ruddershove 10, 8000 Brugge, Belgium.
Vandekerckhove
Y R
YR
Muyldermans
L L
LL
Missault
L H
LH
Matthys
L J
LJ
D000328:Adult; D000368:Aged; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000000981:diagnostic imaging* / Q000601:surgery; D013212:Staphylococcus epidermidis; D013908:Thoracotomy