Reuse of infected cardiac rhythm management devices in the same individual

Infected device explantation is increasingly necessary given the rapid growth in cardiac rhythm management device (CRMD) implantation in China. However, some patients with CRMD infection are unlikely to be capable of paying for a new device. Reassuringly, evidence suggests that reuse of cardiac devices can be safe and feasible. In this study, we evaluated whether explanted cardiac devices, due to infection, can be reimplanted safely within the same individuals.

All patients with CRMD infection between 2007 and 2010 were entered into a computer database. From these, patients that had need for CRMD implantation and reimplantation of their infected device were analyzed for safety and complications.

Sixty patients had CRMD implantation after the infected device removal, and 44 (73.3 %) patients underwent procedures for reimplantation of their infected device. The mean age of the patients was 64.8 ± 16.5 years, and 32 (72.7 %) were male. Indications for device explantation were: pocket infection (86.6 %) and endocarditis (11.4 %). The average follow-up was 20.4 ± 9.0 months. Endocarditis recurred in one (2.3 %) patient with Brugada syndrome at 17 months after reimplantation of a refurbished implantable cardioverter-defibrillator. There were three deaths during the follow-up period secondary to myocardial infarction and cerebral vascular accident. No early battery depletion or device malfunction was identified during follow-up.

Our data emphasize that reimplantation of explanted CRMDs, due to infection, within the same individual is feasible, safe, and effective. Reuse of explanted CRMDs is an alternative choice for people in developing countries.