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The wearable cardioverter defibrillator as a bridge to reimplantation in patients with ICD or CRT-D-related infections

Authors :
L. Castro
S. Pecha
M. Linder
J. Vogler
N. Gosau
C. Meyer
S. Willems
H. Reichenspurner
S. Hakmi
Source :
Journal of Cardiothoracic Surgery, Vol 12, Iss 1, Pp 1-6 (2017)
Publication Year :
2017
Publisher :
BMC, 2017.

Abstract

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.

Details

Language :
English
ISSN :
17498090
Volume :
12
Issue :
1
Database :
Directory of Open Access Journals
Journal :
Journal of Cardiothoracic Surgery
Publication Type :
Academic Journal
Accession number :
edsdoj.3fc2035b02974fa2bd2c741d332eddbc
Document Type :
article
Full Text :
https://doi.org/10.1186/s13019-017-0669-2