Pacemaker-related Endocarditis and Therapeutic Approaches

Endocarditis related to pacemaker lead infection is a rare but serious complication. Diagnosis should be suspected in the presence of recurrent fever, local signs of infection in the pacemaker pocket and pulmonary lesions after pacemaker insertion. Coagulase- positive and -negative staphylococci are the responsible microorganisms in the majority of these infections. Transesophageal echocardiography is the method of choice for imaging a vegetation on an endocavitary pacing lead. The most efficient treatment to eradicate the infection is complete removal of the pacemaker system, either percutaneously or surgically.