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Case Reports
. 2016 May 17:2016:bcr2016215724.
doi: 10.1136/bcr-2016-215724.

Temporary leadless pacing in a patient with severe device infection

Alexander Kypta  1 , Hermann Blessberger  2 , Michael Lichtenauer  3 , Clemens Steinwender  2
Affiliations
Case Reports

Temporary leadless pacing in a patient with severe device infection

Alexander Kypta et al. BMJ Case Rep. .

Abstract

A 64-year-old patient underwent implantation of a transcatheter pacing systems (TPS) for severe lead endocarditis. The patient experienced fever after a dental procedure. On the transoesophageal echocardiogram (TEE), vegetations were attached to the leads. Because the patient was pacemaker dependent, a temporary pacing lead had to be placed. After removal, however, he did not improve. A second TEE showed new vegetations. Ventricular fibrillation occurred spontaneously; so isoprenalin had to be stopped and a new lead was implanted. Vegetations appeared soon after the new temporary lead was placed. We used a TPS as a bridging device, followed by implantation of a resynchronisation system, and explantation of the TPS. After the Micra TPS was implanted, the patient recovered noticeably. All inflammation parameters were negative and an additional (18)F-fluorodeoxyglucose-positron emission tomography/CT imaging also proved to be negative. So a CRT-D device was then implanted, and the TCP was removed.

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Figures

Figure 1
Figure 1
Echo showing vegetation attached to pacemaker leads (arrow points to vegetation). LA, left atrium; RA, right atrium.
Figure 2
Figure 2
PET scan showing no evidence of infection around the implanted TPS (Arrow points to Micra). PET, positron emission tomography; TPS, transcatheter pacing systems.
Figure 3
Figure 3
Ventricular ICD lead, coronary sinus lead and snared TPS. ICD, implantable cardioverter defibrillator; TPS, transcatheter pacing systems.
See this image and copyright information in PMC

References

    1. Ritter P, Duray GZ, Steinwender C et al. . Early performance of a miniaturized leadless cardiac pacemaker: the Micra Transcatheter Pacing Study. Eur Heart J 2015;36:2510–19. 10.1093/eurheartj/ehv214 - DOI - PMC - PubMed
    1. Reynolds D, Duray GZ, Omar R et al. , Micra Transcatheter Pacing Study Group. A leadless intracardiac transcatheter pacing system. N Engl J Med 2016;374:533–41. 10.1056/NEJMoa1511643 - DOI - PubMed
    1. Reddy VY, Exner DV, Cantillon DJ et al. . LEADLESS II study investigators percutaneous implantation of an entirely intracardiac leadless pacemaker. N Engl J Med 2015;373:1125–35. 10.1056/NEJMoa1507192 - DOI - PubMed
    1. Nielsen JC, Gerdes JC, Varma N. Infected cardiac-implantable electronic devices: prevention, diagnosis, and treatment. Eur Heart J 2015;36:2484–90. 10.1093/eurheartj/ehv060 - DOI - PubMed

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