Concomitant leadless pacemaker implantation and lead extraction during an active infection

Area of Science:

• Cardiology
• Infectious Diseases
• Medical Devices

Background:

• Cardiac implantable electronic device (CIED)-related infections necessitate transvenous lead extractions, a procedure complicated by increasing infection rates.
• Current guidelines mandate complete device removal for active infections, posing challenges for pacemaker-dependent individuals.

Purpose of the Study:

• To evaluate the safety and feasibility of simultaneous leadless pacemaker implantation and CIED extraction in patients with active infections.
• To assess the efficacy of this combined approach, particularly in pacemaker-dependent patients.

Main Methods:

• A retrospective review of leadless pacemaker implants between January 2018 and November 2019.
• Identification of patients who underwent concomitant CIED extraction for active infection.
• Recording of baseline characteristics, procedural details, and clinical follow-up data.

Main Results:

• Seventeen patients underwent simultaneous leadless pacemaker implantation and CIED extraction without procedural complications.
• All patients had active CIED infections; 82.4% were pacemaker-dependent.
• No recurrent infections were observed during a median follow-up of 143 days.

Conclusions:

• Simultaneous leadless pacemaker implantation and CIED extraction is a safe and feasible strategy for managing active CIED infections.
• This approach is particularly beneficial for pacemaker-dependent patients requiring device extraction due to infection.