Septicemia in patients with an endocardial pacemaker

Morgan, Glynn; Ginks, W. R.; Siddons, Harold; Leatham, Aubrey

doi:10.1016/0002-9149(79)90308-4

Cited by 101 publications

(33 citation statements)

References 13 publications

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“…The frequency of localized wound infection at the site of the operation is reported to be 2% in current series, 12,13) whereas the rates of septicemia and infective endocarditis following permanent pacemaker implantation are reported to be between 0.5% to 7%. [1][2][3][13][14][15] Among these infections, pacemaker endocarditis, a complication characterized by infection on the pacemaker electrode tip, tricuspid valve, or endocardial areas in contact with the electrode tip, is rare, serious, and difficult to diagnose. Factors known to contribute to the development of this infection include hematoma and inflammation following pacemaker implantation, 2,4,[16][17][18] recurrent surgical interventions for these pacemaker related complications, early manipulation of electrodes following implantation, 19) skin erosion at the site of the pacemaker pocket, and advanced age (over 65).…”

Section: Discussionmentioning

confidence: 99%

“…1) Coagulase negative and positive staphylococci are responsible for most of the infections. [1][2][3][4][5][6][7][8][9][10][11] Echocardiography, as in native and prosthetic valve endocarditis, plays a crucial role in the diagnosis of pacemaker endocarditis. In order to eradicate an infection in permanent pacemaker related endocarditis and septicemia, the pacemaker system should be completely removed either percutaneously or surgically in addition to intensive antibiotic treatment.…”

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confidence: 99%

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Pacemaker Related Endocarditis. Analysis of Seven Cases.

et al. 2002

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SUMMARYVegetative electrode infection following permanent pacemaker implantation is a rare and serious complication. Among 1920 patients who underwent permanent pacemaker implantation in our institute between 1980 and 2000, 7 patients aged 65 to 78 years were diagnosed to have pacemaker related endocarditis. In this study, the clinical course and management strategies for these patients are reviewed. The most frequently encountered factors contributing to development of pacemaker infection were local complications such as postoperative hematoma and inflammation, and recurrent surgical interventions on the pacemaker system. In blood cultures S. aureus was the most common causative microorganism. Echocardiography could be performed in 5 patients. Three patients were referred to open-heart surgery for total removal of the pacemaker system, and one patient had his pacemaker system removed percutaneously. The remaining 3 patients did not agree to either surgical or percutaneous removal. These patients have been under antibiotic therapy for approximately 3 years and they still do not have any signs of a serious infection. Consequently, in patients with permanent pacemakers, infective endocarditis should be considered in the presence of fever and local symptoms. Blood cultures should be obtained and echocardiography should be performed. Complete removal of the pacemaker system with intensive antibiotic treatment is necessary for complete eradication of the infection. However, if percutaneous or surgical removal of the electrodes cannot be done because of high perioperative risk or the patient does not agree to undergo either method, medical treatment with long term antibiotic use may be considered as an alternative. (Jpn Heart J 2002; 43: 475-485) Key words: Pacemaker, Endocarditis VEGETATIVE electrode infection following permanent pacemaker implantation is a serious complication that is difficult to diagnose. A diagnosis of infective endocarditis is established by the presence of clinical signs and symptoms, positive blood cultures, and the visualization of vegetation on the pacemaker elec-

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Pacemaker Related Endocarditis. Analysis of Seven Cases.

et al. 2002

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“…The main indications for lead removal are cardiac device-related infective endocarditis (CDRIE), local device infection (LDI), lead dysfunction, and device upgrading (6). CDRIE is rare, with reported rates ranging from 0.13% to 7% for permanent pacemakers (7,8) and from 0.7% to 1.2% for ICDs (1,9). The presence of CDRIE substantially increases mortality, morbidity, and costs (10 -13).…”

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Diagnosis of Cardiac Device–Related Infective Endocarditis After Device Removal

Dolley

Thuny

Mancini

et al. 2010

JACC: Cardiovascular Imaging

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“…However, because the exact localization of infection (i.e., intracardiac device and/or cardiac valves) may affect the clinical characteristics and therapeutic management of IE, it is of vital importance to analyze specifically the different demographic and clinical data for patients with PM-IE. Furthermore, although increasing amounts of data are available on the pathophysiology and clinical characteristics of PM-IE, data on its incidence remain imprecise, with reported values ranging widely, from 0.13% to 20% [4][5][6][7][8][9][10][11][12]. For these reasons, when we initiated the 1-year prospective survey of patients with IE in France in 1999 (i.e., the princeps study), we planned an ancillary study devoted to describing IE in PM recipients on the basis of the association between IE and PM leads, cardiac valves, or both and the incidence of IE among PM recipients [13].…”

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confidence: 99%

Endocarditis in Patients with a Permanent Pacemaker: A 1-Year Epidemiological Survey on Infective Endocarditis due to Valvular and/or Pacemaker Infection

Duval

Selton-Suty²,

Alla³

et al. 2004

Clinical Infectious Diseases

108

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To describe characteristics of infective endocarditis (IE) in pacemaker (PM) recipients, including the annual incidence and exact localization of IE on PM leads, cardiac valves, or both, we prospectively analyzed 45 PM recipients from a group of 559 patients with definite IE who responded to a population-based survey conducted in France in 1999. Thirty-three patients had definite PM-lead IE (group I), and 12 had valvular IE without evidence of PM involvement (group II). The valvular structure was involved in almost two-thirds of IE cases among PM recipients. Of the 28 patients (62%) with valvular IE, 10 group I patients had tricuspid involvement, and 6 group I patients had left heart-valve involvement. The most frequent causative organisms in groups I and II were staphylococci (82%) and streptococci (50%), respectively. The incidence of age- and sex-standardized IE was 550 cases/million PM recipients per year. The incidence of IE with PM involvement is between that of valvular IE in the general population and prosthetic valve IE.

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Septicemia in patients with an endocardial pacemaker

Cited by 101 publications

References 13 publications

Pacemaker Related Endocarditis. Analysis of Seven Cases.

Pacemaker Related Endocarditis. Analysis of Seven Cases.

Diagnosis of Cardiac Device–Related Infective Endocarditis After Device Removal

Endocarditis in Patients with a Permanent Pacemaker: A 1-Year Epidemiological Survey on Infective Endocarditis due to Valvular and/or Pacemaker Infection

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