Permanent Pacemaker Assembly Infections: Piecemeal or Complete Explantation Approach?

Implantable pacemakers (PM’s) and cardioverter defibrillators (CD) have been accepted worldwide as the standard treatment for various nodal disease and arrhythmias. As with any invasive procedure, PM-associated complications are rare, except in patients who present late in a critically ill state with septic shock. Staphylococcus aureus and Staphylococcus epidermidis were identified as the most common organisms responsible for PM-mediated infections. Appropriate management of M-associated infection involve complete removal of the generator and leads, regardless of the extent and location of the infection. Explantation of the complete PM system has also proven to be one of the most reliable methods to eradicate PM infection. In this study, we report the clinical course of an elderly female who underwent permanent pacemaker implantation (PPI) for complete heart block (CHB) and later developed complications during PM upgradation.