B-PO03-055 CONCOMITANT LEADLESS PACEMAKER IMPLANTATION AND LEAD EXTRACTION DURING AN ACTIVE INFECTION: A LONG-TERM FOLLOW UP

Abstract

An active infection in patients with CIEDs is a life-threatening condition and a Class 1 indication for extraction; extraction may be particularly challenging in pacemaker-dependent patients (PDPs). We report the long-term follow-up of patients for which a novel strategy of concomitant leadless pacemaker implantation (LPI) and CIED extraction during an active infection was utilized. We retrospectively reviewed outcomes for concomitant LPI and CIED extraction for active infections between January 2018 and February 2021. In this strategy, a leadless pacemaker was implanted prior to extracting the infected CIED to eliminate the need for temporary transvenous pacing during and post procedure in PDPs. 39 patients underwent concomitant LPI and CIED extraction during our study period. 11 patients had pocket and 28 systemic infection with vegetations seen in 11. Procedural and clinical success was achieved in 37 (94.9%) and 38 (97.4%) patients, respectively. There was 1 procedural complication (2.6%). During a mean follow-up of 221 days (IQR 32 - 318 days) no persistent or recurrent infections were noted. Four patients underwent reimplantation of CIEDs (upgrade to Micra AV, DDD PCM, CRT-D, CRT-P). Concomitant LPI and CIED extraction during an active infection is a safe and effective approach to managing pacemaker dependent patients with CIED infections.