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Leadless Cardiac Pacemaker Implantation After Lead Extraction in Patients With Severe Device Infection
Author(s) -
KYPTA ALEXANDER,
BLESSBERGER HERMANN,
KAMMLER JUERGEN,
LAMBERT THOMAS,
LICHTENAUER MICHAEL,
BRANDSTAETTER WALTER,
GABRIEL MICHAEL,
STEINWENDER CLEMENS
Publication year - 2016
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.13030
Subject(s) - medicine , lead (geology) , permanent pacemaker , ventricle , surgery , cardiac pacemaker , artificial cardiac pacemaker , cardiology , geomorphology , geology
Leadless Cardiac Pacemaker Implantation After Lead Extraction Background Conventional pacemaker therapy is limited by short‐ and long‐term complications, most notably device infection. Transcatheter pacing systems (TPS) may be beneficial in this kind of patients as they eliminate the need for a device pocket and leads and thus may reduce the risk of re‐infection. Methods We assessed a novel procedure in 6 patients with severe device infection who were pacemaker dependent. After lead extraction a single chamber TPS was implanted into the right ventricle. Results Of the 6 patients who underwent lead extraction due to severe device infection at our institution, 3 were diagnosed with a pocket infection only, whereas the other 3 showed symptoms of both pocket and lead infection. Successful lead extraction and TPS implantation was accomplished in all patients. Four patients were bridged with a temporary pacemaker between 2 hours and 2 days after lead extraction, whereas 2 patients had the TPS implanted during the same procedure just before traditional pacemaker system removal. All patients stayed free of infection during the follow‐up period of 12 weeks. An additional positron emission tomography scan was performed in each patient and indicated no signs of an infection around the TPS. Conclusion Transcather pacemaker implantation was safe and feasible in 6 patients and did not result in re‐infection even if implanted before removal of the infected pacemaker system within the same procedure. Therefore, implantation of a TPS may be an option for patients with severe device infection, especially in those with blocked venous access or who are pacemaker dependent.