Journal du sang et de la lymphe

Introduction: The objectives of this study were to assess the late or early infectious complications associated with the implantation of pacemakers in the cardiology department of the Grand Yoff General Hospital.

Methodology: This was a retrospective study concerning the infectious complications of conventional cardiac stimulation in patients who received a pacemaker between January 1, 2006 and December 31, 2014 in the cardiology department of Grand Yoff General Hospital. The different parameters studied included sociodemographic, clinical, paraclinical data, indications and data on definitive stimulation. Infectious complication, type, treatment and course had also been studied. Early complications are those observed in the first six weeks and late ones beyond six weeks after implantation. The data were analyzed using sphinx 4.5 software. The significance threshold was used for a value of P <0.05.

Results: We had collected 09 cases of infectious complications secondary to definitive cardiac stimulation on 252 implantations either a hospital prevalence of 3.6%. The average age of the patients was 72 years. There was a predominance of women with a sex ratio M/F at 0,5. During the infectious complication phase, fever was present in 2 (0.038%) patients, a leukocytosis found in 3 (5.8%) patients and a high CRP in 10 (19.2%). Blood culture was positive for Staphylococcus aureus in 1.9% of cases.

There are 3 early infectious complications (7.3%) including 2 cases (3.03%) of infection of the pocket and one case infectious endocarditis (1.5%). Late infectious complications were 6 (24%) cases including 5 cases of infection of the pocket (1.98%) and 1 case of endocarditis (0.4%). Extraction followed by sterilization, antibiotic therapy and reimplantation were performed in 8 (0.89%) patients and antibiotic therapy alone in 1 (0.11%) patient. The evolution was favorable in 89% of the cases.

Conclusion: Pacemaker implantation procedures are associated with a risk of infection and the treatment consists of adequate antibiotic therapy combined with extraction of the infected material.