Highlights the clinical challenge of managing cardiac device endocarditis in patients with intermediate size vegetations and significant comorbidities, an area lacking clear guideline recommendations.
Endocarditis in Cardiac Devices (CD), either permanent pacemakers or implantable cardioverter defibrillators, is a severe disease associated with high mortality. The increasing number of patients with implanted cardiac devices explains the rising frequency of endocarditis. The treatment includes medical therapy with complete removal of CD either by surgery or percutaneous extraction depending on the size of vegetation, but there are no clear guidelines about the management of patient with intermediate size vegetations and significant associated comorbidity. We present a case of a 69 year-old man with significant comorbidity and dilated ischemic cardiomyopathy with moderately depressed Left Ventricular Ejection Fraction (LVEF), with a single pass VDD pacemaker presenting with adhered vegetation in the auricular surface of the lead.
No takes yet. Share an insight, caveat, or question.
Clara Bonanad (2013) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: