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Septic complications in patients with permanent pacemakers
S Löffler1, J Kasper, J Postulka
1Institute of Cardiovascular Diseases, Bratislava, Czechoslovakia.
Cor Et Vasa
|January 1, 1988
Summary
Pacemaker infections causing sepsis and endocarditis require foreign body removal. Prompt removal of pacemaker leads, whether extracted or catheterized, led to full recovery in all patients.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Device Infections
Background:
- Implanted pacemakers can lead to serious infections like septicaemia and endocarditis.
- Patients with pacemaker-related infections often have a history of reoperations due to decubitus ulcers.
Purpose of the Study:
- To investigate the diagnosis and management of pacemaker-related sepsis and endocarditis.
- To highlight the critical role of foreign body removal in treating these infections.
Main Methods:
- Diagnosis was confirmed by repeatedly positive haemocultures in nine patients with implanted pacemakers.
- Infection sources included extravascular pacemaker leads (4 patients) and intravascular leads (5 patients).
- Treatment involved antibiotics and removal of the pacemaker lead via extraction or catheterization.
Main Results:
- All nine patients diagnosed with pacemaker-related sepsis and endocarditis recovered after treatment.
- Pacemaker lead removal, either through extraction or catheterization, was universally successful.
- The average interval from pacemaker implantation to infection onset was approximately 5 years.
Conclusions:
- Complete elimination of pacemaker-related sepsis and endocarditis necessitates the removal of the infected foreign body—the pacemaker lead.
- Surgical extraction or catheter-based removal of pacemaker leads are effective strategies for resolving these severe infections.