Late Electrode Sepsis: Clinical Features, Diagnostics and Management. Clinical Cases

Modern cardiology is impossible without implantation of intracardiac devices, such as cardiac pacemakers, resynchronization therapy devices, implantable cardioverter-defibrillators. Meanwhile, as the number of implanted devices increases, so does the number of cases of their infection [1]. At present, sufficient clinical material has been accumulated, demonstrating the obvious features of the course of this type of IE, leading to late diagnosis, the spread of infection to the tricuspid valve and, as a result, to a poor prognosis. The frequency of purulent complications after implantation of pacemakers is from 0.6 to 5.7%; mortality rate varies from 0.13% in local purulent inflammation to 19.9% in bacterial endocarditis and sepsis [2]. Abroad, term electrode sepsis is widely used to reflect the main features of the course of cardiac implantable electronic device infection, which are the predominance of systemic inflammation symptoms and the long-term absence of heart damage signs. We present two typical cases of the course of cardiac implantable electronic device infection, illustrating the difficulties of diagnosing and treating this disease.