Heart 1999;81:88-91 ( January )
Case study
Pacemaker lead infection: report of three cases and review of the
literature
Department of
Cardiology, AZ Sint-Jan, Ruddershove 10, 8000 Brugge, Belgium
Correspondence to: Dr Vandekerckhove.
Accepted for publication 7 July 1998
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.
© 1999 by Heart
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