Pacemaker endocarditis: clinical features and management of 60 consecutive cases.

摘要: Background: The incidence of endocarditis related to pacemakers is increasing, while the diagnosis and management remain difficult. objective this study was evaluate clinical features after implantation (PM) or cardioverter defibrillators (ICD). Methods: We analyzed hospital course 60 consecutive patients (48 men, mean age 68 ± 12 years) admitted our center for PM (n = 59) ICD 1) between 1998 2004. Results: Fever (78%), asthenia (65%), local symptoms (35%) were common. Positive cultures obtained in 53 cases (Staphylococcus 89%). Sixteen (27%) had pulmonary embolism. Vegetations (mean size 15.2 8 mm, range 5 35 mm) found 54 (90%), with transthoracic echocardiography 26 (43%), transesophageal (TEE) 50 (89% 56 who TEE). Devices removed surgically 20) percutaneously 37). In surgical group, vegetations larger (17.9 7 mm vs 13.2 P 0.01). After removal, 42 (70%) a new PM. Mortality factors (6 deaths – follow up 3.4 2 number absence extraction device (P < 0.02). Clinical 37 early onset (within 1 year implantation) did not differ from those late onset. Conclusions: essentially staphylococcal. TEE required vegetations. Complete removal associated favorable outcome.