RT Journal Article
T1 Pacemaker lead endocarditis assessed by a multimodality imaging approach
A1 De Agustín Loeches, José Alberto
A1 Gómez de Diego, José Juan
A1 Sánchez Enrique, Cristina
A1 Vilacosta, Isidre
A1 Pérez De Isla, Leopoldo
A1 Macaya Miguel, Carlos
AB A 75-year-old man with a permanent DDD pacemaker implanted 3 years ago was admitted to our hospital with 1 month history of lowgrade fever and chills. Blood cultures were positive for Staphylococcus schleiferi. Transthoracic echocardiography revealed a large right atrial mass attached to the pacemaker lead, highly suspicious of being a vegetation. A transoesophageal echocardiogram (TEE) was performed showing a well-delineated echogenic mass measuring 11 × 13 mm adherent to the pacemaker lead close to the tricuspid valve, consistent with a vegetation (Panels A and B; Supplementary material online, Videos S1 and S2). Other mobile mass measuring 3 × 10 mm was detected at the atrial lead reaching the superior vena cava. Live three-dimensional TEE improved the spatial assessment of the vegetations, and demonstrated that both were attached to the atrial pacemaker lead (Panels C and D; Supplementary material online, Videos S3 and S4). An 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) scan was performed showing hypermetabolic activity in the pacemaker lead at the level of the right atrium(Panel E). Treatment with daptomycin and gentamicin was introduced promptly and the pacemaker system was percutaneously explanted.The vegetation was crumbled during lead removal, but cultures on the distal intravascular lead segments confirmed the presence of Staphylococcus schleiferi. The patient completed a 4-week course of intravenous antibiotics andhas subsequently remained well. A follow-up FDG PET/CT scan done a month later showed no residual activity at the new pacemaker lead (Panel F).
PB Oxford University Press
SN 0195-668X
YR 2015
FD 2015-06-01
LK https://hdl.handle.net/20.500.14352/131880
UL https://hdl.handle.net/20.500.14352/131880
LA eng
NO Jose Alberto de Agustin, Jose Juan Gomez de Diego, Cristina Sanchez-Enrique, Isidre Vilacosta, Leopoldo Perez de Isla, Carlos Macaya, Pacemaker lead endocarditis assessed by a multimodality imaging approach, European Heart Journal, Volume 36, Issue 37, 1 October 2015, Page 2541, https://doi.org/10.1093/eurheartj/ehv198
DS Docta Complutense
RD 24 mar 2026