[Endocarditis associated with atrial and ventricular cardiac pacing leads. Case report]

The infection of a transvenous lead implanted for cardiac stimulation is a rare, but serious complication. We report observation of a 25-year old man whose Staphylococcus epidermidis sepsis linked to endocarditis was related to atrial and ventricular pacing leads, and was diagnosed after two months of medical treatment. The most important role during the diagnostic process was played by the echocardiographic examination, especially transoesophageal, which revealed the large vegetations on atrial as well as ventricular pacing lead. The diagnosed condition was treated by complete removal of pacing system using open chest surgery and cardiopulmonary pump. After four weeks of vigorous antibiotic treatment, a new DDDR pacing system was implanted, but with epicardial leads.