Severe pacemaker pocket infection during the COVID-19 pandemic, transvenous lead removal

Milos Dusan Babic; Lazar  Angelkov; Milosav Tomovic; Mihailo Jovicic; Darko Boljevic; Ivana Suluburic; Aleksandar Babic; Maja Milosevic; Milovan Bojic; Andrija Djuranovic

doi:10.3855/jidc.15225

Severe pacemaker pocket infection during the COVID-19 pandemic, transvenous lead removal

Authors

Milos Dusan Babic Institute for Cardiovascular Diseases, Dedinje, Belgrade, Serbia
Lazar Angelkov Institute for Cardiovascular Diseases, Dedinje, Belgrade, Serbia
Milosav Tomovic Institute for Cardiovascular Diseases, Dedinje, Belgrade, Serbia
Mihailo Jovicic Institute for Cardiovascular Diseases, Dedinje, Belgrade, Serbia
Darko Boljevic Institute for Cardiovascular Diseases, Dedinje, Belgrade, Serbia
Ivana Suluburic Institute for Cardiovascular Diseases, Dedinje, Belgrade, Serbia
Aleksandar Babic Institute for Cardiovascular Diseases, Dedinje, Belgrade, Serbia
Maja Milosevic Institute for Cardiovascular Diseases, Dedinje, Belgrade, Serbia
Milovan Bojic Institute for Cardiovascular Diseases, Dedinje, Belgrade, Serbia
Andrija Djuranovic Institute for Cardiovascular Diseases, Dedinje, Belgrade, Serbia

DOI:

https://doi.org/10.3855/jidc.15225

Keywords:

device-related endocarditis, pocket infection, pacemaker, transvenous removal, COVID-19

Abstract

Introduction: The estimated infection rate after permanent endocardial lead implantation is between 1% and 2%. Pacemaker lead endocarditis is treated with total removal of the infected device and proper antibiotics. In this case report, we present a patient with delayed diagnosis and treatment due to the COVID-19 outbreak.

Case Report: An 88-year-old, pacemaker dependent woman with diagnosed pacemaker pocket infection was admitted to the University Cardiovascular institute. The patient had a prolonged follow-up time due to the COVID-19 outbreak. She missed her routine checkup and came to her local hospital when the generator had already protruded completely, to the point where she held it in her own hand. Transthoracic echocardiogram showed possible vegetations on the lead. Transesophageal echocardiography was not performed due to the COVID-19 pandemic. On the day after the admission the patient underwent transvenous removal of the pacemaker lead using a 9 French gauge rotational extraction sheathe (Cook Medical). The extracted lead was covered in a thin layer of vegetations. Further follow-ups showed good recovery with no complications.

Conclusions: A case showing delayed treatment of pacemaker pocket infection, due to delayed follow-up time during the COVID-19 pandemic. This patient underwent successful transvenous removal of the infected pacemaker lead, along with adequate antibiotic therapy, which has proven to be the most effective method of treating cardiac device-related endocarditis.

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Published

2021-09-30

How to Cite

Babic MD, Angelkov L, Tomovic M, Jovicic M, Boljevic D, Suluburic I, Babic A, Milosevic M, Bojic M, Djuranovic A (2021) Severe pacemaker pocket infection during the COVID-19 pandemic, transvenous lead removal. J Infect Dev Ctries 15:1277–1280. doi: 10.3855/jidc.15225

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Issue

Vol. 15 No. 09: September 2021

Section

Coronavirus Pandemic

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