Percutaneous aspiration and removal of infected leadless pacemaker vegetation

Introduction: Leadless pacemakers represent an increasingly utilized alternative to traditional pacing methods in those with prior bacteremia or at high risk for infection. The acknowledged resistance to infection is illustrated by the exceedingly rare documentation of it. Methods: We present a case of methicillin-sensitive Staphylococcus aureus endocarditis with associated leadless pacemaker infection necessitating percutaneous aspiration of the device-associated vegetation followed by extraction of the leadless pacemaker. Results: Large vegetation associated with a leadless pacemaker was percutaneously aspirated with a vacuum-assisted aspiration device, followed by successful extraction of the leadless pacemaker. Conclusion: While leadless pacemakers are seldom involved in infective endocarditis, ultrasound evaluation in high-risk patients with an undetermined source is reasonable. Before extraction, it is practical to consider aspiration of large associated vegetations with a vacuum-assisted device.