This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Vilacosta, I. Articles by Martinez Elbal, L. Search for Related Content PubMed PubMed Citation Articles by Vilacosta, I. Articles by Martinez Elbal, L.

Circulation, Vol 89, 2684-2687, Copyright © 1994 by American Heart Association

ARTICLES

Usefulness of transesophageal echocardiography for diagnosis of infected transvenous permanent pacemakers

I Vilacosta, C Sarria, JA San Roman, J Jimenez, JA Castillo, E Iturralde, MJ Rollan and L Martinez Elbal
Department of Cardiology, Hospital Universitario San Carlos, Madrid, Spain.

BACKGROUND: Transesophageal echocardiography is superior to transthoracic echocardiography in detecting left-sided valvular vegetations. There are no data on the value of transesophageal echocardiography in the diagnosis of infected transvenous permanent pacemakers. METHODS AND RESULTS: Transthoracic and transesophageal echocardiography was performed in 10 patients for whom there was clinical suspicion of infected permanent transvenous pacemakers. Transthoracic echocardiography detected pacemaker lead vegetations in 2 patients, whereas transesophageal echocardiography visualized pacemaker lead vegetations in 7 patients. Surgical confirmation was obtained in 6 of these 7 patients. Most patients had more than one pacemaker electrode in place. Local complications at the generator pocket were present in 6 patients. Staphylococcus was the predominant causative organism. CONCLUSIONS: Transesophageal echocardiography is superior to transthoracic echocardiography in the detection of pacemaker lead vegetations.

This article has been cited by other articles:

				Endorsed by the European Society of Clinical Micro, Authors/Task Force Members, G. Habib, B. Hoen, P. Tornos, F. Thuny, B. Prendergast, I. Vilacosta, P. Moreillon, M. de Jesus Antunes, et al. Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009): The Task Force on the Prevention, Diagnosis, and Treatment of Infective Endocarditis of the European Society of Cardiology (ESC) Eur. Heart J., October 1, 2009; 30(19): 2369 - 2413. [Full Text] [PDF]

				M. R. Sohail, D. Z. Uslan, A. H. Khan, P. A. Friedman, D. L. Hayes, W. R. Wilson, J. M. Steckelberg, S. M. Jenkins, and L. M. Baddour Infective Endocarditis Complicating Permanent Pacemaker and Implantable Cardioverter-Defibrillator Infection Mayo Clin. Proc., January 1, 2008; 83(1): 46 - 53. [Abstract] [Full Text] [PDF]

				G. Nucifora, L. Badano, F. Hysko, G. Allocca, P. Gianfagna, and P. Fioretti Pulmonary Embolism and Fever: When Should Right-Sided Infective Endocarditis Be Considered? Circulation, February 13, 2007; 115(6): e173 - e176. [Full Text] [PDF]

				R. J. Cook, T. A. Orszulak, V. T. Nkomo, J. A. Shuford, W. D. Edwards, and J. H. Ryu Aspergillus Infection of Implantable Cardioverter-Defibrillator Mayo Clin. Proc., April 1, 2004; 79(4): 549 - 552. [Abstract] [PDF]

				Task Force Members, D. Horstkotte, F. Follath, E. Gutschik, M. Lengyel, A. Oto, A. Pavie, J. Soler-Soler, G. Thiene, A. von Graevenitz, et al. Guidelines on Prevention, Diagnosis and Treatment of Infective Endocarditis Executive Summary: The Task Force on Infective Endocarditis of the European Society of Cardiology Eur. Heart J., February 1, 2004; 25(3): 267 - 276. [Full Text] [PDF]

				L. M. Baddour, M. A. Bettmann, A. F. Bolger, A. E. Epstein, P. Ferrieri, M. A. Gerber, M. H. Gewitz, A. K. Jacobs, M. E. Levison, J. W. Newburger, et al. Nonvalvular Cardiovascular Device-Related Infections Circulation, October 21, 2003; 108(16): 2015 - 2031. [Full Text] [PDF]

				E. Dumont, C. Camus, F. Victor, C. de Place, D. Pavin, C. Alonso, P. Mabo, and J.C. Daubert Suspected pacemaker or defibrillator transvenous lead infection: Prospective assessment of a TEE-guided therapeutic strategy Eur. Heart J., October 1, 2003; 24(19): 1779 - 1787. [Abstract] [Full Text] [PDF]

				A. del Rio, I. Anguera, J. M. Miro, L. Mont, V. G. Fowler Jr, M. Azqueta, and C. A. Mestres Surgical Treatment of Pacemaker and Defibrillator Lead Endocarditis: The Impact of Electrode Lead Extraction on Outcome Chest, October 1, 2003; 124(4): 1451 - 1459. [Abstract] [Full Text] [PDF]

				V. Vijay and J. P. Gold Late Complications of Cardiac Surgery Card. Surg. Adult, January 1, 2003; 2(2003): 521 - 537. [Full Text]

				A. L. Chamis, G. E. Peterson, C. H. Cabell, G. R. Corey, R. A. Sorrentino, R. A. Greenfield, T. Ryan, L. B. Reller, and V. G. Fowler Jr Staphylococcus aureus Bacteremia in Patients With Permanent Pacemakers or Implantable Cardioverter-Defibrillators Circulation, August 28, 2001; 104(9): 1029 - 1033. [Abstract] [Full Text] [PDF]

				F Victor, C De Place, C Camus, H Le Breton, C Leclercq, D Pavin, P Mabo, and C Daubert Pacemaker lead infection: echocardiographic features, management, and outcome Heart, January 1, 1999; 81(1): 82 - 87. [Abstract] [Full Text]

				J G Voet, Y R Vandekerckhove, L L Muyldermans, L H Missault, and L J Matthys Pacemaker lead infection: report of three cases and review of the literature Heart, January 1, 1999; 81(1): 88 - 91. [Abstract] [Full Text]

				J.-J. Monsuez, M.-C. Douard, Y. Martin-Bouyer, and J.J. Monsuez Catheter Fragments Embolization Angiology, February 1, 1997; 48(2): 117 - 120. [Abstract] [PDF]