Pacemaker infections are caused by bacterial contamination during placement or exposure to airborne bacteria during the healing phase. They are usually easy to treat but require medical attention. Preventive measures include antibiotics and specific guidance on how to take care of oneself.
A pacemaker infection is a bacterial infection that takes root at the site of a pacemaker implant. These implants are relatively common devices used to help people with heart problems keep a regular, steady beat and in most cases consist of electrically charged wires that are inserted into the heart at one end and a small battery on the back that plugs into the heart. located just under the skin on the other. Infections can occur anywhere, but tend to be more common around the battery pack. They are usually caused by contamination during placement or exposure to airborne bacteria during the healing phase. Incisions that don’t heal properly can also make infection more likely. Surgeons and healthcare professionals often tell patients to keep the area clean and dry at all times, especially in the days immediately following the procedure, and may also proactively prescribe a course of antibiotics to reduce the risk.
Pacemaker basics
Pacemakers are medical devices that are surgically inserted into a person’s chest wall to ensure that the person’s heart maintains a steady rhythm. They are commonly used to treat bradycardia, which is a low heart rate, typically below 60 beats per minute, or tachycardia, which is a heart rate that is too fast. Both can be life-threatening if left unmanaged. While some medications can help, actually manipulating the heartbeat pattern is often the easiest way to get consistently good results.
Pacemaker technology is generally considered to be quite advanced and there usually aren’t many side effects for patients who attend all regular checkups and evaluations. Infections are an exception and can happen to almost anyone. They are usually easy to treat, but in most cases, they require medical attention.
Main causes of infection
These types of infections aren’t caused by anything special or unusual; in most cases, they occur in the same way as any infection. The bacteria enter the body’s tissues where they replicate and grow, destroying healthy cells and spreading to new areas until they stop. Some of the biggest risk factors for pacemakers include contaminated surgical tools and exposure to bacterial strains in the operating room or during healing. Your risk also increases if the incision site isn’t cleaned properly or if it doesn’t heal completely.
The infection rate also tends to be slightly higher with temporary devices. A temporary pacemaker may be used to regulate your heart rate for only a short time, such as while recovering from a specific non-permanent heart disease or condition. Unlike the standard designs which are completely enclosed within the body, some of the controls for the temporary devices are actually outside the chest cavity. Access points to the heart and internal body cavities provide more opportunities for bacteria to enter and cause problems.
Primary infections
A primary pacemaker infection is most often a deep infection in the skin pocket made for the device or in the tissue surrounding the area and can typically be traced to a contaminated device or bacterial contamination at the time of device implantation. These infections are generally rare due to the sterile surgical conditions involved in the pacemaker implantation procedure in most hospitals.
Secondary events
Most infections are known as “secondary” and are almost always the result of bacteria entering the blood system. For example, patients who have developed bacteremia or a blood infection, usually from a cut or problem elsewhere in the body, may have those same bacteria migrate and cause a pacemaker infection. If left too long, these types of infections can lead to endocarditis, a serious infection of the muscle layers of the heart.
Treatment and prognosis
Localized infections are usually treated with antibiotics for 14 to 21 days. Any apparent drainage from the site will be cultured to ensure the antibiotics used are the right ones to treat the bacteria. More serious pacemaker infections involving the wires, the pocket of skin surrounding the device, or a systemic blood infection from another source should usually be treated with aggressive antibiotic therapy and surgical removal of the contaminated device. A temporary external pacemaker may be needed while the infection is cleared, as a new, clean, sterile device can usually only be implanted after a person has been cleared of all infection.
Preventive measures
Doctors sometimes prescribe preventive antibiotics at the time of pacemaker surgery in an effort to ward off any infection. Patients are also usually given specific guidance on how to take care of themselves as they heal, as well as what to watch out for. Signs of such an infection include pain and fever. Anyone who suspects they have an infection related to recent pacemaker surgery is generally advised to see a doctor.
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