Bridge pacemaker with an externalized active fixation lead for pacemaker-dependent patients with device infection
Zengli Xiao1, Jinshan He2, Dandan Yang2
1Intensive Care Unit, Peking University People's Hospital, Beijing, China.
Pacing and Clinical Electrophysiology : PACE
|March 31, 2022
Summary
A temporary pacing device, or bridge pacemaker, is safe and effective for patients dependent on pacemakers who have an infected Cardiac Implantable Electronic Device (CIED). This approach helps manage patients until a new device can be safely implanted.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Devices
Background:
- Cardiac Implantable Electronic Device (CIED) infections are a growing concern.
- Pacemaker-dependent patients require temporary pacing during CIED replacement.
- Managing CIED infections in these patients presents unique challenges.
Purpose of the Study:
- To evaluate the safety and efficacy of using a bridge pacemaker with an externalized active fixation lead.
- To assess the outcomes of this strategy in pacemaker-dependent patients with CIED infection.
Main Methods:
- Prospective observational study of 312 pacemaker-dependent patients undergoing bridge pacemaker implantation for CIED infection (April 2013 - August 2020).
- Collection of procedure-related complications and long-term outcomes (reinfection, death) within 1 year post-discharge.
- Data analysis of bridge pacemaker usage duration and lead characteristics.
Main Results:
- Nine patients experienced procedure-related complications (e.g., pericardial tamponade, pneumothorax).
- Three patients had bridge pacemaker-related issues (e.g., lead dislodgement, sensing problems).
- Over 1 year, four patients had CIED reinfection, and three died from cardiac causes.
Conclusions:
- A bridge pacemaker with an externalized active fixation lead is a safe and effective option.
- This strategy provides necessary temporary pacing for pacemaker-dependent patients with CIED infections.
- It facilitates management until definitive device implantation can occur.
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