Pacemaker Infections - Treatment with Total or Partial Pacemaker System Removal*

Summary

During the years 1977 to 1983, 1,458 pacemakers were implanted or reimplanted in our clinic. Seventy-nine patients were treated during the same period for pacemaker System infections. The time interval between the preceding surgical maneuver and the manifest infection was 11.9 ± 10.2 months in the catheter fistulas and 12.2 ± 11.5 months in the pacemaker pocket infections. Forty-one of 79 infections (52%) occurred following the first generator implantation. In 33/43 (76.7%) patients with partial pacemaker System removal, recurrent infection occurred 19.6 ± 17.2 months later. The infection was treated with similar surgical maneuvers resulting in subsequent infections in 9 patients after 9.8 ± 7.2 months. In the patients with total pacemaker System removal infection developed in 2/25 (8%). The infection resulted in septicemia in 9 patients. Major surgical Intervention was necessary for removal of the infected endocardial electrode in 7 patients.

According to our experience there are no grounds for partial removal of the pacemaker System if infection occurs. The primary results may be satisfactory but reinfection will appear in the majority of the patients after a period of several months.

Key words

Pacemaker - Infection