Outcomes of concurrent and delayed leadless pacemaker implantation following extraction of infected cardiovascular implantable electronic device.

IF 2.1 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Interventional Cardiac Electrophysiology Pub Date : 2024-12-05 DOI:10.1007/s10840-024-01960-2

Bilawal Nadeem, Surik Sedrakyan, Amel Fatima, Mirza Mehmood Ali Baig, Ali Ahmed, Mifrah Rahat Khan Sherwani, John Wylie

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引用次数: 0

Abstract

Introduction: The optimal reimplantation strategies following the removal of infected cardiovascular implantable electronic devices (CIEDs) remain inadequately understood. Given the limitations and risks associated with traditional approaches, the investigation of alternative devices, such as leadless pacemakers (LPs), has gained attention due to their potentially lower infection risk.

Methods: We reviewed literature sources including PubMed, Scopus, and Embase, utilizing a combination of search terms. The inclusion criterion was leadless pacemaker (LP) implantation following lead removal (LR) of infected CIEDs, while the exclusion criterion was LR for noninfectious indications. Study endpoints encompassed patient outcomes during follow-up.

Results: Our literature review yielded 827 articles, of which 22 met the inclusion criteria, encompassing a cohort of 657 patients who underwent LR followed by LP implantation. A total of 295 (44.9%) patients underwent concurrent LP implantation during the LR procedure. The rest underwent delayed procedures, and the overall duration between LR of infected CIED and LP implantation was 4.32 ± 3.9 days. A total of 194 (29.5%) patients had systemic CIED infections, whereas 153 (23.3%) had isolated pocket infections. In our patient cohort, procedural complications were scarce. Over a mean follow-up period of 13.3 ± 9.4 months, pacemaker syndrome was observed in 4 patients (0.61%), and 3 patients (0.46%) experienced persistent or recurrent infections.

Conclusion: Our review finds both concurrent and delayed LP implantation after infected CIED extraction to be safe, with low reinfection rates and minimal complications. LPs could also serve as a bridge to CRT re-implantation minimizing the use of temporary pacing systems.

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感染性心血管植入式电子装置取出后并发和延迟无铅起搏器植入的结果。

在移除感染的心血管植入式电子装置（cied）后，最佳的再植策略仍然没有得到充分的了解。考虑到传统方法的局限性和风险，研究替代设备，如无铅起搏器（lp），由于其潜在的较低感染风险而受到关注。方法：我们回顾了文献来源，包括PubMed， Scopus和Embase，利用搜索词的组合。纳入标准为感染cied取铅后植入无铅起搏器（LP），排除标准为非感染性指征的LR。研究终点包括随访期间的患者结局。结果：我们的文献综述获得了827篇文章，其中22篇符合纳入标准，包括657名接受LR和LP植入的患者。共有295例（44.9%）患者在LR手术期间同时进行了LP植入。其余患者延迟手术，从感染CIED的LR到LP植入的总时间为4.32±3.9天。194例（29.5%）患者发生全身性CIED感染，153例（23.3%）患者发生孤立性口袋感染。在我们的患者队列中，手术并发症很少。平均随访13.3±9.4个月，4例患者（0.61%）出现起搏器综合征，3例患者（0.46%）出现持续或复发感染。结论：我们的综述发现感染性CIED拔牙后并发和延迟LP植入是安全的，再感染率低，并发症少。LPs也可以作为CRT重新植入的桥梁，最大限度地减少临时起搏系统的使用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Interventional Cardiac Electrophysiology 医学-心血管系统

CiteScore

4.30

自引率

11.10%

发文量

320

审稿时长

4-8 weeks

期刊介绍： The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.