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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
Summary
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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