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Related Experiment Videos

Septicemia in patients with an endocardial pacemaker.

G Morgan, W Ginks, H Siddons

    The American Journal of Cardiology
    |August 1, 1979
    PubMed
    Summary

    Septicemia from long-term endocardial pacing occurred in 1% of patients. Prompt removal of the pacing system and epicardial system insertion led to survival, unlike leaving the endocardial system in place.

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    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.

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