{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:49:58Z","timestamp":1753876198947,"version":"3.41.2"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,2,7]],"date-time":"2022-02-07T00:00:00Z","timestamp":1644192000000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,2,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Cardiac implantable electronic device (CIED)-related infections are associated with severe morbidity and mortality. Few cases have previously documented both lead endocarditis and lead rupture simultaneously.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>We describe the case of a 73-year-old man with a dual-chamber pacemaker presenting with subacute endocarditis and recurrent cholangitis. A few months prior, the patient was diagnosed with localized colon cancer and Streptococcus sanguinis lead endocarditis based on nuclear imaging. He was given prolonged antibiotic therapy and lead explantation was to be performed after sigmoidectomy. During the following weeks, his condition worsened and he was readmitted for biliary sepsis. A chest X-ray revealed, incidentally, a complete ventricular lead rupture. Pacemaker electrogram showed ventricular undersensing, loss of ventricular capture, and high impedance. As his health declined, removal of the pacemaker was deemed unreasonable and the patient died of biliary sepsis in the next few weeks.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>We describe the case of an asymptomatic intracardiac lead fracture in the setting of colon cancer and a medically managed Streptococcus lead infection. As this complication occurred during lead infection, bacterial damage may have weakened the lead over time. As illustrated by the patient\u2019s outcomes, long-term antibiotic therapy should only be used in cases unsuitable for device removal. Complete hardware removal remains the first-line therapy in patients with CIED-related infections.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytac054","type":"journal-article","created":{"date-parts":[[2022,2,9]],"date-time":"2022-02-09T02:50:51Z","timestamp":1644375051000},"source":"Crossref","is-referenced-by-count":0,"title":["Pacemaker lead rupture in a patient with subacute endocarditis: a case report"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1441-4445","authenticated-orcid":false,"given":"Lorenzo","family":"Caratti di Lanzacco","sequence":"first","affiliation":[{"name":"Cardiology Department, Cliniques Universitaires St-Luc, Universit\u00e9 Catholique de Louvain, Av. Hippocrate 10, 1200 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2220-6849","authenticated-orcid":false,"given":"Aur\u00e9lien","family":"Wauters","sequence":"additional","affiliation":[{"name":"Cardiology Department, Cliniques Universitaires St-Luc, Universit\u00e9 Catholique de Louvain, Av. Hippocrate 10, 1200 Brussels, Belgium"},{"name":"Cardiology Department, Clinique St-Pierre, Avenue Reine Fabiola 9, 1340 Ottignies-Louvain-La-Neuve, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,2,7]]},"reference":[{"key":"2022021503343250900_ytac054-B1","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1093\/europace\/euy050","article-title":"2018 EHRA expert consensus statement on lead extraction: recommendations on definitions, endpoints, research trial design, and data collection requirements for clinical scientific studies and registries: endorsed by APHRS\/HRS\/LAHRS","volume":"20","author":"Bongiorni","year":"2018","journal-title":"Europace"},{"key":"2022021503343250900_ytac054-B2","doi-asserted-by":"crossref","first-page":"3075","DOI":"10.1093\/eurheartj\/ehv319","article-title":". 2015 ESC Guidelines for the management of infective endocarditis: the Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM)","volume":"36","author":"Habib","year":"2015","journal-title":"Eur Heart J"},{"key":"2022021503343250900_ytac054-B3","doi-asserted-by":"crossref","first-page":"1851","DOI":"10.1016\/j.jacc.2007.01.072","article-title":"Management and outcome of permanent pacemaker and implantable cardioverter-defibrillator infections","volume":"49","author":"Sohail","year":"2007","journal-title":"J Am Coll Cardiol"},{"key":"2022021503343250900_ytac054-B4","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1161\/CIRCULATIONAHA.120.046723","article-title":"Prevalence of infective endocarditis in streptococcal bloodstream infections is dependent on streptococcal species","volume":"142","author":"Chamat-Hedemand","year":"2020","journal-title":"Circulation"},{"key":"2022021503343250900_ytac054-B5","doi-asserted-by":"crossref","first-page":"3237","DOI":"10.1093\/eurheartj\/ehz327","article-title":"Prevalence of infective endocarditis in patients with positive blood cultures: a Danish nationwide study","volume":"40","author":"\u00d8stergaard","year":"2019","journal-title":"Eur Heart J"},{"key":"2022021503343250900_ytac054-B6","doi-asserted-by":"crossref","first-page":"bcr2018224799","DOI":"10.1136\/bcr-2018-224799","article-title":"Second look at Streptococcus sanguinis and the colon","volume":"2018","author":"Thomas","year":"2018","journal-title":"BMJ Case Rep"},{"key":"2022021503343250900_ytac054-B7","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1093\/clinids\/15.1.33","article-title":"Streptococcal and enterococcal bacteremia in patients with cancer","volume":"15","author":"Awada","year":"1992","journal-title":"Clin Infect Dis"},{"key":"2022021503343250900_ytac054-B8","doi-asserted-by":"crossref","first-page":"2246","DOI":"10.3390\/jcm9072246","article-title":"Usefulness of 18F-FDG PET\/CT in patients with cardiac implantable electronic device suspected of late infection","volume":"9","author":"Rubini","year":"2020","journal-title":"JCM"},{"key":"2022021503343250900_ytac054-B9","first-page":"yty063","article-title":"Case report: recurrent thrombosis of an old lead of a DDDR pacemaker mimicking lead infection","volume":"2","author":"Panagiotis","year":"2018","journal-title":"Eur Heart J Case Rep"},{"key":"2022021503343250900_ytac054-B10","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1055\/s-2007-1020206","article-title":"Lead fracture in pacemaker patients","volume":"35","author":"Alt","year":"1987","journal-title":"Thorac Cardiovasc Surg"},{"key":"2022021503343250900_ytac054-B11","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1111\/j.1540-8159.1989.tb01929.x","article-title":"The tricuspid valve: an unusual site of endocardial pacemaker lead fracture","volume":"12","author":"Clarke","year":"1989","journal-title":"Pacing Clin Electrophysiol"},{"key":"2022021503343250900_ytac054-B12","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1093\/europace\/eus003","article-title":"Abrasions of the outer silicone insulation of endocardial leads in their intracardiac part: a new mechanism of lead-dependent endocarditis","volume":"14","author":"Kolodzinska","year":"2012","journal-title":"Europace"},{"key":"2022021503343250900_ytac054-B13","doi-asserted-by":"crossref","first-page":"2012","DOI":"10.1093\/eurheartj\/ehaa010","article-title":"European Heart Rhythm Association (EHRA) international consensus document on how to prevent, diagnose, and treat cardiac implantable electronic device infections\u2014endorsed by the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS), the Latin American Heart Rhythm Society (LAHRS), International Society for Cardiovascular Infectious Diseases (ISCVID), and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"41","author":"Blomstr\u00f6m-Lundqvist","year":"2020","journal-title":"Eur Heart J"}],"container-title":["European Heart Journal - 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