The hybrid permanent cardiac pacing – in a patient with high infection risk

<ns3:p>Infective complications of permanent cardiac pacing severely influence long-term outcomes despite system removal and targeted antibiotics. In-hospital mortality reaches 4,6 % and 1-year – 14-17%. A case of a 68-year-old patient was described. The patient suffered from infective endocarditis, which caused the extraction of a formerly implanted standard dual-chamber pacemaker and insertion of bioprosthesis of the aortic valve and epicardial DDD system implantation. After 9 years during follow-up increase of impedance and threshold on ventricular lead have been observed. Due to temporal pacemaker dependency, the decision was made to implant a leadless MICRA AV device with preservation of active atrial pacing through an epicardial DDD system programmed to AAI mode. No procedural complications were observed. There was no electrical interference between implanted systems.</ns3:p>