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Septicemia secondary to impacted infected pacemaker wire. Successful treatment by removal with cardiopulmonary bypass

C M Chavez, J H Conn

    The Journal of Thoracic and Cardiovascular Surgery
    |May 1, 1977
    PubMed

    Insights

    Pacemaker electrode infections can spread to the heart, causing sepsis. Radical surgical removal of infected pacemaker leads and wires, even with extracorporeal circulation, is necessary for successful treatment.

    Area of Science:

    • Cardiology
    • Infectious Diseases
    • Medical Device Infections

    Background:

    • Intravenous pacemaker electrodes are crucial for cardiac rhythm management.
    • Repeated generator and lead manipulations increase infection risk.
    • Endocardial infection can lead to severe systemic complications like septicemia.

    Observation:

    • A 78-year-old male developed an intravenous pacemaker electrode infection after multiple procedures.
    • Infection spread to the endocardium, causing septicemia due to Serratia marcescens and Staphylococcus epidermidis.
    • The pacemaker electrode tip was embedded in the right ventricle, attached to the tricuspid valve.

    Findings:

    • Medical treatment and external traction failed to resolve the infection.
    • Thoracotomy with extracorporeal circulation was required for infected pacemaker electrode removal.
    • Post-removal cultures confirmed the causative organisms.
    • No recurrence was observed two years after infected electrode removal.

    Implications:

    • Radical surgical intervention is essential for managing severe pacemaker lead infections with septicemia.
    • Early recognition and aggressive treatment can prevent life-threatening complications.
    • This case highlights the importance of sterile techniques and monitoring for device-related infections.

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