Permanent Pacemaker Wire Vegetation in the Right Atrium
A 64-year-old patient presented with methicillin-sensitive staphylococcal bacteremia 4 weeks after intravenous implantation of a ventricular pacemaker. The patient continued to have positive blood cultures despite antibiotic therapy with nafcillin. Multiple pulmonary abscesses were noted on chest radiograph and CT scan of the chest. A transesophageal echocardiogram revealed the images presented in Figs 1⇓ and 2⇓. This patient was managed with pacemaker wire removal through venotomy followed by a course of antibiotics. At the time of pacemaker removal, infection of the pacemaker pocket was also noted, and cultures revealed the same organism.
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke’s Hospital and Texas Heart Institute, 6720 Bertner, MC 4-265, Houston, TX 77030.
- Copyright © 1995 by American Heart Association