The wearable cardioverter defibrillator as a bridge to reimplantation in patients with ICD or CRT-D-related infections
Abstract Background The approach to treat device infection in patients with implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy defibrillator (CRT-D) is a challenging procedure. Optimal treatment is complete extraction of the infected device. To protect these patients f...
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| Format: | Article |
| Language: | English |
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BMC
2017-11-01
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| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13019-017-0669-2 |
| _version_ | 1817988766634082304 |
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| author | L. Castro S. Pecha M. Linder J. Vogler N. Gosau C. Meyer S. Willems H. Reichenspurner S. Hakmi |
| author_facet | L. Castro S. Pecha M. Linder J. Vogler N. Gosau C. Meyer S. Willems H. Reichenspurner S. Hakmi |
| author_sort | L. Castro |
| collection | DOAJ |
| description | Abstract Background The approach to treat device infection in patients with implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy defibrillator (CRT-D) is a challenging procedure. Optimal treatment is complete extraction of the infected device. To protect these patients from sudden cardiac arrest while waiting for reimplantation and to avoid recurrent infection, a wearable cardioverter defibrillator (WCD) seems to be a valuable solution. Therefore, we investigated the management and outcome of patients with ICD or CRT-D infections using the WCD as a bridge to re-implantation after lead extraction procedures. Methods We conducted a retrospective study on consecutive patients who underwent ICD or CRT-D removal due to device-related local or systemic infections. All patients were prescribed a WCD at our center between 01/2012 and 10/2015. All patients returned to our outpatient clinic for regular ICD or CRT-D monitoring initially 1 and 3 months after reimplantation followed by 6-months intervals. Results Twenty-one patients (mean age 65.0 ± 8.0 years, male 76.2%) were included in the study. Complete lead extraction was achieved in all patients. While waiting for reimplantation one patient experienced a symptomatic episode of sustained ventricular tachycardia. This episode was converted successfully into sinus rhythm by a single 150 J shock. Mean follow-up time 392 ± 206 days, showing survival rate of 100% and freedom from reinfection in all patients. Conclusion The WCD seems to be a valuable bridging option for patients with ICD or CRT-D infections, showing no recurrent device infection. |
| first_indexed | 2024-04-14T00:38:32Z |
| format | Article |
| id | doaj.art-3fc2035b02974fa2bd2c741d332eddbc |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-04-14T00:38:32Z |
| publishDate | 2017-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-3fc2035b02974fa2bd2c741d332eddbc2022-12-22T02:22:16ZengBMCJournal of Cardiothoracic Surgery1749-80902017-11-011211610.1186/s13019-017-0669-2The wearable cardioverter defibrillator as a bridge to reimplantation in patients with ICD or CRT-D-related infectionsL. Castro0S. Pecha1M. Linder2J. Vogler3N. Gosau4C. Meyer5S. Willems6H. Reichenspurner7S. Hakmi8Department of Cardiovascular Surgery, University Heart Center HamburgDepartment of Cardiovascular Surgery, University Heart Center HamburgDepartment of Cardiovascular Surgery, University Heart Center HamburgDepartment of Cardiology, Electrophysiology, University Heart Center HamburgDepartment of Cardiology, Electrophysiology, University Heart Center HamburgDepartment of Cardiology, Electrophysiology, University Heart Center HamburgDepartment of Cardiology, Electrophysiology, University Heart Center HamburgDepartment of Cardiovascular Surgery, University Heart Center HamburgDepartment of Cardiovascular Surgery, University Heart Center HamburgAbstract Background The approach to treat device infection in patients with implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy defibrillator (CRT-D) is a challenging procedure. Optimal treatment is complete extraction of the infected device. To protect these patients from sudden cardiac arrest while waiting for reimplantation and to avoid recurrent infection, a wearable cardioverter defibrillator (WCD) seems to be a valuable solution. Therefore, we investigated the management and outcome of patients with ICD or CRT-D infections using the WCD as a bridge to re-implantation after lead extraction procedures. Methods We conducted a retrospective study on consecutive patients who underwent ICD or CRT-D removal due to device-related local or systemic infections. All patients were prescribed a WCD at our center between 01/2012 and 10/2015. All patients returned to our outpatient clinic for regular ICD or CRT-D monitoring initially 1 and 3 months after reimplantation followed by 6-months intervals. Results Twenty-one patients (mean age 65.0 ± 8.0 years, male 76.2%) were included in the study. Complete lead extraction was achieved in all patients. While waiting for reimplantation one patient experienced a symptomatic episode of sustained ventricular tachycardia. This episode was converted successfully into sinus rhythm by a single 150 J shock. Mean follow-up time 392 ± 206 days, showing survival rate of 100% and freedom from reinfection in all patients. Conclusion The WCD seems to be a valuable bridging option for patients with ICD or CRT-D infections, showing no recurrent device infection.http://link.springer.com/article/10.1186/s13019-017-0669-2Wearable cardioverter defibrillatorCIED-infectionICD infectionSudden cardiac arrestLead/ device extractionVentricular tachycardia |
| spellingShingle | L. Castro S. Pecha M. Linder J. Vogler N. Gosau C. Meyer S. Willems H. Reichenspurner S. Hakmi The wearable cardioverter defibrillator as a bridge to reimplantation in patients with ICD or CRT-D-related infections Journal of Cardiothoracic Surgery Wearable cardioverter defibrillator CIED-infection ICD infection Sudden cardiac arrest Lead/ device extraction Ventricular tachycardia |
| title | The wearable cardioverter defibrillator as a bridge to reimplantation in patients with ICD or CRT-D-related infections |
| title_full | The wearable cardioverter defibrillator as a bridge to reimplantation in patients with ICD or CRT-D-related infections |
| title_fullStr | The wearable cardioverter defibrillator as a bridge to reimplantation in patients with ICD or CRT-D-related infections |
| title_full_unstemmed | The wearable cardioverter defibrillator as a bridge to reimplantation in patients with ICD or CRT-D-related infections |
| title_short | The wearable cardioverter defibrillator as a bridge to reimplantation in patients with ICD or CRT-D-related infections |
| title_sort | wearable cardioverter defibrillator as a bridge to reimplantation in patients with icd or crt d related infections |
| topic | Wearable cardioverter defibrillator CIED-infection ICD infection Sudden cardiac arrest Lead/ device extraction Ventricular tachycardia |
| url | http://link.springer.com/article/10.1186/s13019-017-0669-2 |
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