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Bacteraemia after leadless pacemaker implantation
  • +6
  • Christophe Garweg,
  • bert Vandenberk,
  • Sander Jentjens,
  • stefaan Foulon,
  • Patrick Hermans,
  • Patricia Poels,
  • Peter Haemers,
  • Joris Ector,
  • Rik Willems
Christophe Garweg
KU Leuven University Hospitals Leuven Gasthuisberg Campus
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bert Vandenberk
KU Leuven University Hospitals Leuven Gasthuisberg Campus
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Sander Jentjens
KU Leuven University Hospitals Leuven Gasthuisberg Campus
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stefaan Foulon
KU Leuven University Hospitals Leuven Gasthuisberg Campus
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Patrick Hermans
KU Leuven University Hospitals Leuven Gasthuisberg Campus
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Patricia Poels
KU Leuven University Hospitals Leuven Gasthuisberg Campus
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Peter Haemers
KU Leuven University Hospitals Leuven Gasthuisberg Campus
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Joris Ector
KU Leuven University Hospitals Leuven Gasthuisberg Campus
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Rik Willems
KU Leuven University Hospitals Leuven Gasthuisberg Campus
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Peer review status:ACCEPTED

27 Apr 2020Submitted to Journal of Cardiovascular Electrophysiology
28 Apr 2020Submission Checks Completed
28 Apr 2020Assigned to Editor
03 May 2020Reviewer(s) Assigned
13 May 2020Review(s) Completed, Editorial Evaluation Pending
15 May 2020Editorial Decision: Revise Minor
06 Jul 20201st Revision Received
06 Jul 2020Submission Checks Completed
06 Jul 2020Assigned to Editor
06 Jul 2020Reviewer(s) Assigned
08 Jul 2020Review(s) Completed, Editorial Evaluation Pending
10 Jul 2020Editorial Decision: Accept

Abstract

Background: Transvenous permanent pacemaker related infection is a severe condition associated with significant morbidity and mortality. Leadless pacemakers may be more resistant to bacterial seeding during bloodstream infection because of its small surface area and encapsulation in the right ventricle. This study reports the incidence and outcomes of bacteraemia in patients implanted with a Micra leadless pacemaker. We present 18F-FDG PET/CT findings obtained in a sub-group of patients. Methods: We report a retrospective cohort study of 155 patients who underwent a Micra TPS implant procedure at the University Hospitals of Leuven between July 2015 and July 2019. We identified the patients who developed an episode of bacteraemia, proved by ≥2 positive blood cultures. Results: Of the 155 patients, 15 patients presented an episode of bacteraemia at a median of 226 days (range: 3-1129) days after the implant procedure. Gram positive species accounted for 73.3% (n=11) of the bacteraemia including Staphylococcus (n=5), Enterococcus (n=3) and Streptococcus (n=3). The source of infection was identified in 9 patients (60%) including endocarditis in 4 patients, urinary tract in 3 patients, and skin in 2 patients. 18F-FDG PET/CT imaging performed in 6 patients did not show sign of infection around the leadless pacemaker. Bacteraemia was resolved in all patients after adequate antibiotherapy. Four patients died early during follow up. For all other patients, there were no recurrence of bacteraemia during a median follow up of 263 days (range 15-1134). Conclusion: In our small cohort, no leadless pacemaker endocarditis was observed among patients with bacteraemia.