Malplacement of a pacemaker lead--a rare cause for aortic valve endocarditis.

Infective endocarditis of native valves following pacemaker implantation is rare but can be associated with serious complications, approaching a mortality of up to 25%. Recent publications report a frequency of pacemaker related endocarditis between 0.5 and 7%. Due to anatomical reasons the tricuspid valve is mostly affected in these patients, with involvement of the left heart valves usually secondary. We report an incidence of native aortic valve endocarditis due to a misplaced pacemaker lead into the left heart.