Recurrent Cardiovascular Implantable Electronic Device Infection: A Case Report

Introduction: Cardiac implantable electronic devices (CIEDs) are widely utilized to manage various cardiac conditions, including arrhythmias and heart failure. Despite their therapeutic benefits, CIEDs carry the risk of serious complications, such as infections, which present significant challenges, particularly in pediatric patients. Case Presentation: We present the case of a 6-year-old male patient with a medical history of tetralogy of Fallot (TOF) repair and epicardial permanent pacemaker (PPM) implantation, who presented with recurrent pocket infections. Following the initial pacemaker insertion, the patient exhibited swelling, erythema, and purulent drainage at the implantation site, necessitating device removal and replacement. Despite subsequent interventions and antibiotic therapy, the patient experienced recurrent infections, requiring multiple lead extractions and open-heart surgery for complete device removal and pulmonary valve replacement. Conclusions: The CIED infections in pediatric patients are severe and often necessitate complex management strategies, including device removal and prolonged antibiotic therapy. Careful evaluation of predisposing factors and strategic planning of interventions are crucial to reducing the risk of complications and improving patient outcomes.