Therapy of Cardiac Device Pocket Infections with Vacuum‐Assisted Wound Closure—Long‐Term Follow‐Up

Abstract

Cardiac device infections are serious complications that require aggressive treatment strategies, including interventional or surgical lead extraction. Here we describe the long-time follow-up of vacuum-assisted closure (V.A.C.) treatment in five patients with local cardiac device infection (LDI). In these patients the device was removed, the electrodes were shortened, and a V.A.C. treatment was applied. The primary endpoint was defined as time to re-LDI. Three patients had LDI of a pacemaker pocket, whereas two presented with an infection of their ICD pocket. The V.A.C. treatment was applied for 34.4 ± 17.9 days. The mean hospitalization time was 38.6 ± 19.2 days. The follow-up period was assessed for 34.6 ± 19.2 months. Only one patient developed re-LDI, 69 days after removal of the device. The other four patients did not show any signs of reinfection during the follow-up period. None of the five patients sustained serious adverse events. V.A.C. treatment may be an option for selected patients with LDI who refuse a laser-guided lead extraction or surgical removal of the electrodes as the primary therapy.