Why the study?
What is the optimal management strategy for pacemaker infective endocarditis in patients with a concomitant prosthetic valve?
What is the optimal management strategy for pacemaker infective endocarditis in patients with a concomitant prosthetic valve?
Complete extraction of the infected pacemaker system is essential in patients with prosthetic valves, though optimal timing and antibiotic duration remain controversial.
Essential extraction in pacemaker endocarditis with prosthetic valves; case data leave timing, antibiotics, and reimplantation open for trials.
Infective endocarditis is not uncommon in patients with both a permanent pacemaker system and a prosthetic valve. No guidelines exist to aid management. The recommendations for pacemaker infective endocarditis alone are limited and contradictory. We present a case trilogy and literature review that highlights these shortcomings and the challenges facing physicians. Complete extraction of the infected pacemaker system is essential. The timing of extraction, duration of antibiotic therapy, and timing of reimplantation are all controversial. The presence of a concomitant prosthetic valve exacerbates these dilemmas further.
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Jenkins et al. (2007) studied this question.
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