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Infected endocardial pacemaker electrodes: successful open intracardiac removal
U Niederhäuser1, L K von Segesser, T P Carrel
1Clinic for Cardiovascular Surgery, University Hospital, Zürich, Switzerland.
Pacing and Clinical Electrophysiology : PACE
|February 1, 1993
Summary
Open intracardiac removal of infected pacing electrodes is a safe and effective procedure for patients with persistent infections or complications. This method ensures complete removal when less invasive techniques fail, leading to positive long-term outcomes.
Area of Science:
- Cardiology
- Cardiac Surgery
Background:
- Infected pacing electrodes pose significant risks, including bacteremia, endocarditis, and device malfunction.
- Extraction by closed or percutaneous methods is not always feasible for deeply embedded or infected electrodes.
Purpose of the Study:
- To evaluate the long-term results of open intracardiac removal of infected pacing electrodes.
- To assess the safety and efficacy of this surgical approach for complex cases.
Main Methods:
- Retrospective analysis of seven patients undergoing open intracardiac removal of 19 infected pacing electrodes between 1985 and 1990.
- Procedures included removal of atrial and ventricular electrodes, with or without cardiopulmonary bypass (CPB).
- Simultaneous implantation of new pacing systems was performed in five patients.
Main Results:
- No early or late mortality was observed in the seven patients.
- All patients were alive at a mean follow-up of 33 months, with a mean New York Heart Association Class of 1.3.
- Infection was controlled in all cases with antimicrobial chemotherapy, and the postoperative period was free of major complications.
Conclusions:
- Open intracardiac removal of infected pacing electrodes is a safe procedure with no major complications.
- This surgical approach is mandatory for infected electrodes that cannot be extracted by less invasive methods.