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Positron emission tomography in patients with suspected pacing system infections may play a critical role in

Sylvain Ploux1, Annalisa Riviere, Sana Amraoui

  • 1University Bordeaux 2, Hopital Cardiologique Haut Leveque, Bordeaux-Pessac, France.

Heart Rhythm
|April 6, 2011
PubMed
Abstract

Insights

Positron emission tomography/computed tomography (FDG-PET/CT) scanning can identify pacing lead infections in patients with recurrent unexplained fever. Increased FDG uptake along a pacemaker lead is a reliable indicator of active infection.

Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Infectious Diseases

Background:

  • Pacemaker recipients may experience recurrent hospitalizations due to unexplained infections.
  • Standard investigations, including transesophageal echocardiography, may not identify the source of infection.

Purpose of the Study:

  • To evaluate the utility of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in diagnosing pacing material infection.
  • To assess FDG-PET/CT for identifying lead endocarditis in challenging cases.

Main Methods:

  • Ten patients with suspected pacing system infection and 40 control pacemaker recipients underwent FDG-PET/CT.
  • Increased FDG uptake along a pacing lead guided decisions for system removal.
  • Control group underwent scanning for malignancy investigation.

Main Results:

  • FDG-PET/CT showed increased FDG uptake in 6 out of 10 patients with suspected infection.
  • These 6 patients underwent complete system removal, and lead cultures were positive.
  • In 4 patients, the pacing system remained without signs of active lead endocarditis.

Conclusions:

  • FDG-PET/CT scanning shows promise for diagnosing pacing lead endocarditis in difficult cases.
  • Elevated FDG uptake along a pacing lead is a dependable marker for active infection.

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