Abstract
BackgroundThe approach to treat device infection in patients with implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy defibrillator (CRT-D) is a challenging procedure. Optimal treatment is complete extraction of the infected device. To protect these patients from sudden cardiac arrest while waiting for reimplantation and to avoid recurrent infection, a wearable cardioverter defibrillator (WCD) seems to be a valuable solution.Therefore, we investigated the management and outcome of patients with ICD or CRT-D infections using the WCD as a bridge to re-implantation after lead extraction procedures.MethodsWe conducted a retrospective study on consecutive patients who underwent ICD or CRT-D removal due to device-related local or systemic infections. All patients were prescribed a WCD at our center between 01/2012 and 10/2015. All patients returned to our outpatient clinic for regular ICD or CRT-D monitoring initially 1 and 3 months after reimplantation followed by 6-months intervals.ResultsTwenty-one patients (mean age 65.0 ± 8.0 years, male 76.2%) were included in the study. Complete lead extraction was achieved in all patients. While waiting for reimplantation one patient experienced a symptomatic episode of sustained ventricular tachycardia. This episode was converted successfully into sinus rhythm by a single 150 J shock.Mean follow-up time 392 ± 206 days, showing survival rate of 100% and freedom from reinfection in all patients.ConclusionThe WCD seems to be a valuable bridging option for patients with ICD or CRT-D infections, showing no recurrent device infection.
Highlights
The approach to treat device infection in patients with implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy defibrillator (CRT-D) is a challenging procedure
We conducted a retrospective study on consecutive patients who underwent ICD or Cardiac Resynchronization Therapy (CRT)-D removal due to local or systemic infection at our center between January 2012 and October 2015
Patient information was de-identified in all cases and all patients were prescribed a wearable cardioverter defibrillator (WCD) (LifeVest, ZOLL, Pittsburgh, PA, USA)
Summary
The approach to treat device infection in patients with implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy defibrillator (CRT-D) is a challenging procedure. Due to the increasing indications for cardiac resynchronization-therapy devices (CRT-D) and implantable cardioverter defibrillator devices (ICD) for heart failure therapy and prevention of sudden cardiac arrest (SCA), the implantation rates for cardiovascular implantable electronic devices (CIEDs) have increased over time [1, 2]. In this context, there is a rising number of devices that have to be extracted due to local or systemic device-related infections. Patients still remain at risk for SCA
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have