Late Purulent Pacemaker Pocket Infection Caused by Staphylococcus Epidermidis: Serious Complications of In Situ Management

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Abstract
The pathophysiology of late pacemaker pocket infection is poorly understood. We report three cases of late infection caused by Staphylococcus epidermidis. Despite initial local conservative management ultimate removal of the entire pacing system was required. In late pacemaker pocket infection we recommend initial removal of the entire pacing system and replacement on the contralateral side. When retrieval of the lead system requires open-heart surgery epicardial wires should be placed.

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