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[Pacemaker endocarditis]

R López Rodríguez1, M Rodríguez Framil, A Hermida Ameijeiras

  • 1Servicio de Medicina Interna, Hospital Clinico Universitario, Complejo Hospitalario Universitario de Santiago de Compostela, 15701 Santiago de Compostela, A Coruña.

Anales De Medicina Interna (Madrid, Spain : 1984)
|November 14, 2006
PubMed

Insights

Pacemaker endocarditis, a serious complication of permanent transvenous pacing, often presents as fever or bacteremia. Early diagnosis via blood cultures and echocardiography, alongside surgical intervention, is crucial for successful treatment and reduced mortality.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Device Complications

Context:

  • Pacemaker endocarditis is a rare but severe complication associated with permanent transvenous pacing systems.
  • Common clinical presentations include fever syndrome and Gram-positive bacteremia, necessitating prompt diagnostic evaluation.
  • Risk factors identified include repeated device manipulation and pre-existing diabetes mellitus.

Purpose:

  • To retrospectively analyze cases of pacemaker endocarditis diagnosed between 1989 and 2003.
  • To identify common causative microorganisms, risk factors, diagnostic methods, and treatment outcomes.
  • To evaluate the role of echocardiography in diagnosing pacemaker endocarditis.

Summary:

  • A retrospective study reviewed six cases of pacemaker endocarditis, with Staphylococci identified as the most frequent pathogen.
  • Transthoracic echocardiography demonstrated a 66% diagnostic yield in this series, despite known limitations.
  • All patients underwent successful surgical treatment involving cardiopulmonary bypass and new system implantation, with no relapses observed.

Impact:

  • This study highlights the importance of early diagnosis and aggressive surgical management for pacemaker endocarditis.
  • Effective treatment strategies can lead to favorable outcomes, with an overall mortality rate of 17% in this cohort.
  • Findings underscore the need for vigilance regarding pacemaker infections, particularly in patients with risk factors like diabetes and device manipulation.

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