title: Temporary leadless pacing in a patient with severe device infection.
abstract: A 64-year-old patient underwent implantation of a transcatheter pacing systems (TPS) for severe lead endocarditis. The patient experienced fever after a dental procedure. On the transoesophageal echocardiogram (TEE), vegetations were attached to the leads. Because the patient was pacemaker dependent, a temporary pacing lead had to be placed. After removal, however, he did not improve. A second TEE showed new vegetations. Ventricular fibrillation occurred spontaneously; so isoprenalin had to be stopped and a new lead was implanted. Vegetations appeared soon after the new temporary lead was placed. We used a TPS as a bridging device, followed by implantation of a resynchronisation system, and explantation of the TPS. After the Micra TPS was implanted, the patient recovered noticeably. All inflammation parameters were negative and an additional (18)F-fluorodeoxyglucose-positron emission tomography/CT imaging also proved to be negative. So a CRT-D device was then implanted, and the TCP was removed.
authors.affiliation: Cardiovascular Division, Linz General Hospital Johannes Kepler University School of Medicine, Linz, Austria.
authors.forename: Alexander
authors.initials: A
authors.lastname: Kypta
authors.affiliation: Linz General Hospital Johannes Kepler University School of Medicine, Linz, Austria.
authors.forename: Hermann
authors.initials: H
authors.lastname: Blessberger
authors.affiliation: Clinic of Internal Medicine II, Paracelsus Medical University of Salzburg, Salzburg, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Lichtenauer
authors.affiliation: Linz General Hospital Johannes Kepler University School of Medicine, Linz, Austria.
authors.forename: Clemens
authors.initials: C
authors.lastname: Steinwender
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002304:Cardiac Pacing, Artificial / Q000379:methods; D020878:Device Removal; D004696:Endocarditis / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000382:microbiology*; D016459:Prosthesis-Related Infections / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents