Infection frequently complicates implantation of cardiac devices, and management often requires replacement of the device. Risk factors principally relate to relative immunosuppression or practices surrounding insertion of the device. Clinical management varies by how deep the infection is in relation to the device, how the patient is systemically and whether or not septic vegetations are present on echocardiography. The cause is most commonly staphylococcal, which should be considered in empirical antimicrobial use.