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[Infections with cardiac implantable electronic device]

Ava Azari1, Ingibjörg Kristjánsdóttir2, Paolo Gatti3

  • 1leg läkare, -Karolinska universitets-sjukhuset, Stockholm; -institutionen för medicin, -Karolinska institutet.

Lakartidningen
|September 12, 2025
PubMed

Insights

Lead extraction is safe for patients with device infections. Systemic infection, kidney disease, and frailty are key mortality risks to consider before the procedure.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Device Management

Background:

  • Cardiac implantable electronic devices (CIEDs) are crucial for managing cardiac conditions.
  • Infections associated with CIEDs pose significant risks, including systemic and local spread.
  • Lead extraction is a complex procedure with potential risks and benefits.

Purpose of the Study:

  • To evaluate the safety and effectiveness of lead extraction in patients with CIED infections.
  • To identify mortality risk factors associated with lead extraction in this patient population.
  • To inform pre-procedure risk stratification strategies for CIED lead extraction.

Main Methods:

  • Retrospective analysis of patients undergoing CIED lead extraction due to systemic or local infections.
  • Assessment of 30-day and 1-year mortality rates.
  • Statistical analysis to identify independent predictors of mortality, including comorbidities and frailty.

Main Results:

  • Lead extraction demonstrated safety and effectiveness in patients with CIED infections.
  • The 30-day mortality rate was 2.5%, and the 1-year mortality rate was 9.9%.
  • Systemic infection, chronic kidney disease, and frailty (Clinical Frailty Scale 5-7) were independently associated with increased mortality.

Conclusions:

  • Lead extraction is a viable option for managing CIED infections.
  • Identifying patients with systemic infection, chronic kidney disease, or significant frailty is crucial for risk stratification.
  • Pre-procedure assessment of these risk factors can optimize patient selection and management for lead extraction.

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