Fungal Leadless Pacemaker Endocarditis Managed by Percutaneous Vacuum-Assisted Evacuation of Vegetation, Pacemaker Extraction, and Replacement.

Leadless cardiac pacemakers (LCPs) mitigate the risks of traditional transvenous devices such as lead fracture and infection. Two LCPs are clinically available, using either a helix or tined active fixation approach. There are rare reports of LCP infection-all involving the tined device. We report the first pathologically confirmed fungal endocarditis involving a helix-based LCP. This was successfully managed by catheter-based mechanical vacuum evacuation of the vegetation, followed by device extraction and replacement.