Can transvenous pacemaker lead removal and antibiotics successfully treat pacemaker lead endocarditis with large vegetations?
Transvenous pacemaker lead removal combined with antibiotics can be a successful treatment strategy for pacemaker lead endocarditis even in the presence of large vegetations (>2 cm).
Pacemaker lead endocarditis is treated with total removal of the infected device and proper antibiotics. The outcomes of patients undergoing percutaneous lead extraction for large vegetations (>2 cm) have not yet been shown. In this case report, we present two patients with pacemaker lead endocarditis with large vegetations of maximum diameter 2.4 cm and 3.2 cm. The first patient had multiple vegetations attached to the tricuspid and mitral valves and developed septic emboli to the brain, lung, and liver. The second patient had a large, persistent vegetation on the tricuspid valve, even two weeks after complete removal of the leads. Both patients were successfully treated with transvenous pacemaker lead removal and antibiotics.
Cho et al. (Wed,) studied this question.