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Echocardiography in detecting implantable cardioverter defibrillator lead endocarditis: case report

Josip Vincelj1, Bruno Barsić, Igor Rudez

  • 1Department of Cardiovascular Diseases, Dubrava University Hospital, Zagreb, Croatia. jvincelj@kbd.hr

Acta Clinica Croatica
|November 1, 2011
PubMed

Insights

Lead endocarditis, a rare complication of implantable cardioverter defibrillator (ICD) implantation, can be fatal. This case highlights successful surgical treatment for methicillin-resistant Staphylococcus epidermidis (MRSE) endocarditis in an ICD patient.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Device Complications

Background:

  • Implantable cardioverter defibrillators (ICDs) are crucial for managing cardiac arrhythmias.
  • Lead endocarditis is a serious, though infrequent, complication associated with ICD implantation.

Observation:

  • A 53-year-old male patient with an ICD presented with systemic symptoms including fever and malaise.
  • Echocardiography revealed a vegetation on the ICD lead, confirmed by transesophageal echocardiography as a mobile mass in the right atrium.

Findings:

  • Blood cultures identified methicillin-resistant Staphylococcus epidermidis (MRSE) as the causative agent.
  • The patient underwent surgical removal of the infected ICD lead and implantation of new epicardial leads.

Implications:

  • Prompt diagnosis and surgical intervention are critical for managing ICD lead endocarditis.
  • This case underscores the importance of considering device-related infections in patients with ICDs presenting with systemic symptoms.
  • Successful treatment outcomes can be achieved with aggressive management, even in complex cases involving resistant organisms.

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