OBJECTIVEPermanent epicardial pacemaker is seldom used clinically and it is even less likely to be used for the treatment of seriously ill pacing-dependent patients with cardiac electronic device related endocarditis.

METHODWe retrospectively analyzed the feasibility and efficacy of permanent epicardial pacing for the treatment of 3 pacing-dependent patients with cardiac electronic device related endocarditis, who were treated by removal of all pacemaker devices and reimplantation of permanent epicardial pacing system combined with antibiotics. The reason of using epicardial pacing system was as follows: uncontrolled sepsis (case 1); big vegetation on the electrode of pacemaker and tricuspid valve but not a candidate for open heart surgery because of high operative risk (case 2); occlusion of superior vena cava (case 3).

RESULTSAll 3 patients were cured with the treatment of extraction of infected pacing system, re-implanted permanent epicardial pacing system and antibiotics. The permanent epicardial pacemaker worked well during the 2-12 months follow-up period and there was no recurrence of infection.

CONCLUSIONSPermanent epicardial pacing is useful and efficient in treatment of seriously ill and high risk pacing-dependent patients with cardiac device related endocarditis.