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Severe pacemaker pocket infection during the COVID-19 pandemic, transvenous lead removal

Milos Dusan Babic1, Lazar Angelkov1, Milosav Tomovic1

  • 1Institute for Cardiovascular Diseases, Dedinje, Belgrade, Serbia.

Journal of Infection in Developing Countries
|October 20, 2021
PubMed
Abstract

Insights

Delayed treatment for pacemaker lead endocarditis, a serious infection, occurred due to COVID-19 disruptions. Successful transvenous lead removal and antibiotics resolved the infection in an elderly patient.

Area of Science:

  • Cardiology
  • Infectious Diseases

Background:

  • Permanent endocardial lead implantation carries a 1-2% risk of infection.
  • Pacemaker lead endocarditis necessitates complete device removal and antibiotic treatment.

Observation:

  • An 88-year-old pacemaker-dependent woman presented with a severe pacemaker pocket infection.
  • Delayed diagnosis and treatment occurred due to missed follow-up appointments during the COVID-19 pandemic.
  • The pacemaker generator had fully protruded, and echocardiography revealed possible vegetations on the lead.

Findings:

  • Transvenous removal of the infected pacemaker lead was successfully performed using a rotational extraction sheath.
  • The extracted lead showed vegetation, confirming endocarditis.
  • The patient recovered well with appropriate antibiotic therapy.

Implications:

  • This case highlights the challenges in managing device-related infections during pandemics.
  • Prompt diagnosis and intervention, including transvenous lead extraction, remain crucial for treating pacemaker lead endocarditis.
  • Maintaining regular follow-up care is vital for early detection of complications.
Keywords:
COVID-19device-related endocarditispacemakerpocket infectiontransvenous removal

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