Skip to main content
Journal cover image

Leadless pacemaker implantation after lead extraction for cardiac implanted electronic device infection.

Publication ,  Journal Article
Bicong, L; Allen, JC; Arps, K; Al-Khatib, SM; Bahnson, TD; Daubert, JP; Frazier-Mills, C; Hegland, DD; Jackson, KP; Jackson, LR; Lewis, RK ...
Published in: J Cardiovasc Electrophysiol
March 2022

BACKGROUND: Cardiac implanted electronic device (CIED) pocket and systemic infection remain common complications with traditional CIEDs and are associated with high morbidity and mortality. Leadless pacemakers may be an attractive pacing alternative for many patients following complete hardware removal for a CIED infection by eliminating surgical pocket-related complications as well as lower risk of recurrent complications. OBJECTIVE: To describe use and outcomes associated with leadless pacemaker implantation following extraction of a CIED system due to infection. METHODS: Patient characteristics and postprocedural outcomes were described in patients who underwent leadless pacemaker implantation at Duke University Hospital between November 11, 2014 and November 18, 2019, following CIED infection and device extraction. Outcomes of interest included procedural complications, pacemaker syndrome, need for system revision, and recurrent infection. RESULTS: Among 39 patients, the mean age was 71 ± 17 years, 31% were women, and the most frequent primary pacing indication was complete heart block (64.1%) with 9 (23.1%) patients being pacemaker dependent at the time of Micra implantation. The primary organism implicated in the CIED infection was Staphylococcus aureus (43.6%). Nine of the 39 patients had a leadless pacemaker implanted before or on the same day as their extraction procedure, and the remaining 30 patients had a leadless pacemaker implanted after their extraction procedure. During follow-up (mean 24.8 ± 14.7 months) after leadless pacemaker implantation, there were a total of 3 major complications: 1 groin hematoma, 1 femoral arteriovenous fistula, and 1 case of pacemaker syndrome. No patients had evidence of recurrent CIED infection after leadless pacemaker implantation. CONCLUSIONS: Despite a prior CIED infection and an elevated risk of recurrent infection, there was no evidence of CIED infection with a mean follow up of over 2 years following leadless pacemaker implantation at or after CIED system removal. Larger studies with longer follow-up are required to determine if there is a long-term advantage to implanting a leadless pacemaker versus a traditional pacemaker following temporary pacing when needed during the periextraction period in patients with a prior CIED infection.

Duke Scholars

Published In

J Cardiovasc Electrophysiol

DOI

EISSN

1540-8167

Publication Date

March 2022

Volume

33

Issue

3

Start / End Page

464 / 470

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Prosthesis-Related Infections
  • Pacemaker, Artificial
  • Middle Aged
  • Humans
  • Female
  • Electronics
  • Device Removal
  • Cardiovascular System & Hematology
  • Aged, 80 and over
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Bicong, L., Allen, J. C., Arps, K., Al-Khatib, S. M., Bahnson, T. D., Daubert, J. P., … Piccini, J. P. (2022). Leadless pacemaker implantation after lead extraction for cardiac implanted electronic device infection. J Cardiovasc Electrophysiol, 33(3), 464–470. https://doi.org/10.1111/jce.15363
Bicong, Li, John Carson Allen, Kelly Arps, Sana M. Al-Khatib, Tristram D. Bahnson, James P. Daubert, Camille Frazier-Mills, et al. “Leadless pacemaker implantation after lead extraction for cardiac implanted electronic device infection.J Cardiovasc Electrophysiol 33, no. 3 (March 2022): 464–70. https://doi.org/10.1111/jce.15363.
Bicong L, Allen JC, Arps K, Al-Khatib SM, Bahnson TD, Daubert JP, et al. Leadless pacemaker implantation after lead extraction for cardiac implanted electronic device infection. J Cardiovasc Electrophysiol. 2022 Mar;33(3):464–70.
Bicong, Li, et al. “Leadless pacemaker implantation after lead extraction for cardiac implanted electronic device infection.J Cardiovasc Electrophysiol, vol. 33, no. 3, Mar. 2022, pp. 464–70. Pubmed, doi:10.1111/jce.15363.
Bicong L, Allen JC, Arps K, Al-Khatib SM, Bahnson TD, Daubert JP, Frazier-Mills C, Hegland DD, Jackson KP, Jackson LR, Lewis RK, Pokorney SD, Sun AY, Thomas KL, Piccini JP. Leadless pacemaker implantation after lead extraction for cardiac implanted electronic device infection. J Cardiovasc Electrophysiol. 2022 Mar;33(3):464–470.
Journal cover image

Published In

J Cardiovasc Electrophysiol

DOI

EISSN

1540-8167

Publication Date

March 2022

Volume

33

Issue

3

Start / End Page

464 / 470

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Prosthesis-Related Infections
  • Pacemaker, Artificial
  • Middle Aged
  • Humans
  • Female
  • Electronics
  • Device Removal
  • Cardiovascular System & Hematology
  • Aged, 80 and over