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This study evaluates the clinical features and management of endocarditis following pacemaker and defibrillator implantation.

Pacemaker Endocarditis: Clinical Features and Management of 60 Consecutive Cases

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This study evaluates the clinical features and management of endocarditis following pacemaker and defibrillator implantation.
Analyzed hospital course of 60 consecutive patients with pacemaker or defibrillator endocarditis from 1998 to 2004.
Performed transthoracic echocardiography and transesophageal echocardiography for diagnosis of vegetations.
Surgical and percutaneous device removal methods evaluated for treatment outcomes.
Fever was present in 78% of cases and positive cultures found in 53 cases (89% Staphylococcus).
90% had vegetations, with larger sizes in the surgical group (mean 17.9 mm vs 13.2 mm, P = 0.01).
70% of patients received a new pacemaker after device removal, and absence of extraction was linked to higher mortality (P < 0.02).

Population

60 consecutive patients (48 men, mean age 68 +/- 12 years) admitted for pacemaker (n=59) or ICD (n=1) endocarditis between 1998 and 2004.

Intervention

Device removal (surgical or percutaneous) and medical management

Outcome

Clinical features, management outcomes, and mortality factorshard clinical

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May support extraction in device endocarditis; leaves open prospective validation of vegetation burden.

Massoure et al. (2007) studied this question.

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