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A Rare Case of Persistent Bacteremia: Leadless Micra Pacemaker Endocarditis

Himax Patel1, Sean Harrell1, Haitham Hreibe1

  • 1Augusta University Medical Center, 1120 15th Street, Augusta, GA 30912, USA.

Case Reports in Cardiology
|January 30, 2023
PubMed

Insights

Leadless pacing systems offer low infection risks, but infections can still occur. Persistent bacteremia necessitates device evaluation and potential removal to prevent complications.

Area of Science:

  • Electrophysiology
  • Infectious Diseases

Background:

  • Leadless pacing systems have significantly reduced complications and infection rates compared to traditional pacemakers.
  • The unique design of leadless devices contributes to their inherent resistance to infections.

Observation:

  • Despite their advantages, leadless pacing systems are not entirely immune to device-related infections.
  • This report highlights a case where infection associated with a leadless pacing system occurred.

Findings:

  • Persistent bacteremia in patients with leadless pacemakers warrants investigation.
  • Transesophageal echocardiogram or intracardiac echocardiography can detect vegetation on the leadless device.
  • Device extraction combined with empiric intravenous antibiotics is recommended if vegetation is identified.

Implications:

  • Early recognition and management of leadless pacemaker infections are crucial.
  • A waiting period of at least two weeks before re-implantation is advised after infected device removal to prevent reinfection.
  • Further research into preventing and managing leadless device infections is warranted.

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