Why the study?
Does transesophageal echocardiography improve the detection of pacemaker lead vegetations compared to transthoracic echocardiography in patients with suspected infected permanent transvenous pacemakers?
Does transesophageal echocardiography improve the detection of pacemaker lead vegetations compared to transthoracic echocardiography in patients with suspected infected permanent transvenous pacemakers?
Transesophageal echocardiography is superior to transthoracic echocardiography for detecting pacemaker lead vegetations in patients with suspected device infection.
TEE may detect more pacemaker lead vegetations than TTE in suspected infection; leaves open need for prospective validation before changing practice.
BACKGROUND: Transesophageal echocardiography is superior to transthoracic echocardiography in detecting left-sided valvular vegetations. There are no data on the value of transesophageal echocardiography in the diagnosis of infected transvenous permanent pacemakers. METHODS AND RESULTS: Transthoracic and transesophageal echocardiography was performed in 10 patients for whom there was clinical suspicion of infected permanent transvenous pacemakers. Transthoracic echocardiography detected pacemaker lead vegetations in 2 patients, whereas transesophageal echocardiography visualized pacemaker lead vegetations in 7 patients. Surgical confirmation was obtained in 6 of these 7 patients. Most patients had more than one pacemaker electrode in place. Local complications at the generator pocket were present in 6 patients. Staphylococcus was the predominant causative organism. CONCLUSIONS: Transesophageal echocardiography is superior to transthoracic echocardiography in the detection of pacemaker lead vegetations.
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Vilacosta et al. (1994) studied this question.
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