JACC. Case reports · 2025
First Reported Case of Infection Involving a Leadless Atrial Pacemaker.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Karki Sadichhya, Rosenberg Jonathan, Abraham Nihil, Fatima Amber, Kawasaki Raymond, Metzl Mark
Аннотация
BACKGROUND: Leadless pacemakers were developed to reduce infection risk compared with transvenous systems. However, real-world data on device-related infections in newer models like the leadless atrial pacemaker (AVEIR AR) remain limited.
CASE SUMMARY: A 70-year-old man with atrial fibrillation and prior methicillin-resistant Staphylococcus aureus (MRSA) pacemaker infection presented with acute respiratory failure and MRSA bacteremia 3 months after implantation of the leadless atrial pacemaker. Imaging showed a cystic mass attached to the device. The pacemaker was percutaneously extracted under intracardiac echocardiography guidance. Persistent bacteremia prompted aspiration of the residual mass using a percutaneous aspiration device (AlphaVac system). Cultures confirmed MRSA.
DISCUSSION: This represents the first documented case of endocarditis involving a leadless atrial pacemaker system. Although leadless pacemakers are designed to minimize infection, they are not immune to serious complications.
TAKE-HOME MESSAGES: Leadless pacemakers can still develop infections. Percutaneous aspiration-guided removal is a feasible management option. Prompt recognition and intervention are essential.
CASE SUMMARY: A 70-year-old man with atrial fibrillation and prior methicillin-resistant Staphylococcus aureus (MRSA) pacemaker infection presented with acute respiratory failure and MRSA bacteremia 3 months after implantation of the leadless atrial pacemaker. Imaging showed a cystic mass attached to the device. The pacemaker was percutaneously extracted under intracardiac echocardiography guidance. Persistent bacteremia prompted aspiration of the residual mass using a percutaneous aspiration device (AlphaVac system). Cultures confirmed MRSA.
DISCUSSION: This represents the first documented case of endocarditis involving a leadless atrial pacemaker system. Although leadless pacemakers are designed to minimize infection, they are not immune to serious complications.
TAKE-HOME MESSAGES: Leadless pacemakers can still develop infections. Percutaneous aspiration-guided removal is a feasible management option. Prompt recognition and intervention are essential.