Septicemia in patients with an endocardial pacemaker.

Area of Science:

• Cardiology
• Infectious Diseases
• Medical Devices

Background:

• Long-term pacing is a crucial treatment for cardiac conditions.
• Endocardial pacing systems carry a risk of infection, including septicemia.
• Understanding septicemia incidence and outcomes in pacing patients is vital.

Purpose of the Study:

• To determine the incidence, mechanism, course, and treatment of septicemia in patients with long-term endocardial pacing.
• To evaluate the effectiveness of different treatment strategies for septicemia in this patient group.

Main Methods:

• Retrospective analysis of 1,235 patients treated with endocardial pacing between 1964 and 1977.
• Identification of patients who developed septicemia and analysis of causative organisms.
• Comparison of treatment outcomes based on whether the endocardial pacing system was retained or removed.

Main Results:

• Septicemia developed in 12 patients (1%), with Staphylococcus aureus being the most common pathogen (10 cases).
• Treatment success was significantly higher when the endocardial pacing system was promptly removed and an epicardial system inserted (4/4 survivors).
• Retaining the endocardial system resulted in lower success rates (2/7), with recurrence in 3 patients and mortality in 2.

Conclusions:

• Septicemia is a rare but serious complication of endocardial pacing.
• Prompt removal of the infected endocardial pacing system, potentially with thoracotomy and epicardial system insertion, is the preferred treatment strategy.
• This approach significantly improves survival rates compared to retaining the infected system.