Jenkins Shona M M, Hawkins Nathaniel M, Hogg Kerry J
Department of Cardiology, Stobhill Hospital, Glasgow, UK.
Pacing Clin Electrophysiol. 2007 Oct;30(10):1279-83. doi: 10.1111/j.1540-8159.2007.00852.x.
Infective endocarditis is not uncommon in patients with both a permanent pacemaker system and a prosthetic valve. No guidelines exist to aid management. The recommendations for pacemaker infective endocarditis alone are limited and contradictory. We present a case trilogy and literature review that highlights these shortcomings and the challenges facing physicians. Complete extraction of the infected pacemaker system is essential. The timing of extraction, duration of antibiotic therapy, and timing of reimplantation are all controversial. The presence of a concomitant prosthetic valve exacerbates these dilemmas further.
感染性心内膜炎在同时拥有永久性起搏器系统和人工瓣膜的患者中并不罕见。目前尚无指导管理的指南。仅针对起搏器感染性心内膜炎的建议有限且相互矛盾。我们展示了一个三联病例及文献综述，突出了这些不足以及医生面临的挑战。彻底取出感染的起搏器系统至关重要。取出的时机、抗生素治疗的持续时间以及重新植入的时机均存在争议。同时存在人工瓣膜会使这些困境进一步加剧。
