Pace-maker related infective endocarditis
Abstract
Background: To describe clinical picture, treatment and outcome of the disease in patients with pace-maker related endocarditis.
Methods: All the patients fulfilling the Duke patomorphological and clinical criteria for infective endocarditis on pacemaker wire or near it are included. Clinical and demographic data are recorded as well as the time since the implantation of pacemaker, site of infection, portal of entry, causative agent, size and localization of vegetation, mode of operation and outcome of the disease.
Results: Since the year 1984 10 episodes of paced-maker related endocarditis in 9 patients (8 males, 1 female) were treated at the Department of Infectious Diseases and that represents 2,5% of all episodes of infective endocarditis treated at the department. The causative micro-organisms were isolated in 9 out of 10 episodes, mostly there were coagulase negative staphylococci. One patient died before the operation and another patient after the operation. Overall mortality was 20%. Eight out of 9 patients were operated. Complete pacedmaker system or only retained leads were extracted. None of the patients who survived the operation had a relapse of the disease.
Conclusions: Pace-maker related endocarditis is rare. Complete cure is usually impossible without combined surgical therapy and long-term antibiotic treatment.
Downloads
References
Karchmer AW, Longworth DL. Infections of intracardiac devices. Cardiol Clin 2003; 21: 253–71.
Cabell CH, Heidenreich PA, Chu VH, et al. Increasing rates of cardiac device infections among Medicare beneficiaries: 1990–1999. Am Heart J 2004; 147: 582–6.
Duval X, Selton-Suty C, Alla F, et al. Endocarditis in patients with a permanent pacemaker: A 1-year epidemiological survey on infective endocarditis due to valvular and/or pacemaker infection. Clin Infect Dis 2004; 39: 68–74.
The task force on infective endocarditis of the european society of cardiology. Guidelines on prevention, diagnosis and treatment of infective endocarditis. Executive summary. Eur Heart J 2004; 25: 267–76.
Piper C, Körfer R, Horstkotte D. Prosthetic valve endocarditis. Heart 2001; 85: 590–3.
Kojic EM, Darouiche RO. Candida infection of medical devices. Clin Microbiol Rev 2004; 17: 255–67.
Molina JE. Undertreatment and overtreatment of patients with infected antiarrythmic implantable device. Ann Thorac Surg 1997; 63: 504–9.
Laguno M, Miró Ó, Font C, de la Sierra A. Pacemaker-related endocarditis. Cardiology 1998; 90: 244–8.
Voet JG, Vandekerckhove YR, Muyxldermans LL, Missault LH, Matthys LJ. Pacemaker lead infection: report of three cases and review of the literature. Heart 1999; 81: 88–91.
Miralles A, Moncada V, Chevez H, Rodriguez R, Granados J, Castells E. Pacemaker endocarditis, Approach for lead extraction in endocarditis with large vegetations. Ann Thorac Surg 2001; 72: 2130–2.
Meier HK, Gray ME, John RM. Endocardial pacemaker or defibrillator leads with infected vegetations: A single – center experience and consequences of transvenous extraction. Am Heart J 2003; 146: 339–44.
Arber N, Pras E, Copperman Y, et al. Pacemaker endocarditis. Report of 44 cases and review of literature. Medicine 1994; 73: 299–305.
Klug D, Lacroix D, Savoye C, et al. Systemic infection related to endocarditis on pacemaker leads. Circulation 1997; 95: 2098–107.
Cacoub P, Leprince P, Nataf P, et al. Pacemaker infective endocarditis. Am J Cardiol 1998; 82: 480–4.
Zakynthinos E, Vassilakopoulos T, Mpetsou A, Malagari E, Roussos C, Zakynthinos SG. Fever in patients with pacemakers; the necessity of performing transesophageal echocardiography early. Intensive Care Med 2000; 26: 1157–61.
The Author transfers to the Publisher (Zdravniški vestnik/Slovenian Medical Journal) all economic copyrights following form Article 22 of the Slovene Copyright and Related Rights Act (ZASP), including the right of reproduction, the right of distribution, the rental right, the right of public performance, the right of public transmission, the right of public communication by means of phonograms and videograms, the right of public presentation, the right of broadcasting, the right of rebroadcasting, the right of secondary broadcasting, the right of communication to the public, the right of transformation, the right of audiovisual adaptation and all other rights of the author according to ZASP.
The aforementioned rights are transferred non-exclusively, for an unlimited number of editions, for the term of the statutory
The Author can make use of his work himself or transfer subjective rights to others only after 3 months from date of first publishing in the journal Zdravniški vestnik/Slovenian Medical Journal.
The Publisher (Zdravniški vestnik/Slovenian Medical Journal) has the right to transfer the rights, acquired parties without explicit consent of the Author.
The Author consents that the Article be published under the Creative Commons BY-NC 4.0 (attribution-non-commercial) or comparable licence.
