Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Endowed Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Prognosis after lead extraction in patients with cardiac implantable electronic devices infection: Comparison of lead-related infective endocarditis with pocket infection in a Japanese single-center experience.
Journal Formal name:Journal of arrhythmia
Abbreviation:J Arrhythm
ISSN code:18804276/18832148
Domestic / ForeginDomestic
Publisher Japanese Heart Rhythm Society
Volume, Issue, Page 35(4),pp.654-663
Author and coauthor Nishii Nobuhiro, Morimoto Yoshimasa, Miyoshi Akihito, Tsukuda Saori, Miyamoto Masakazu, Kawada Satoshi, Nakagawa Koji, Watanabe Atsuyuki, Nakamura Kazufumi, Morita Hiroshi, Morimatsu Hiroshi, Kusano Nobuchika, Kasahara Shingo, Shoda Morio, Ito Hiroshi
Publication date 2019/08
Summary Background:The increase in the use of cardiac implantable electronic devices (CIEDs) has been associated with an increase in CIED-related infections. Transvenous lead extraction is safe and effective for patients with CIED-related infections; however, the mortality rate in these patients is high. The prognosis after transvenous lead extraction in Japanese patients, especially those with lead-related infective endocarditis, has not been evaluated. Then, the purpose of this study is to clarify the prognosis after transvenous lead extraction in Japanese patients with CIED-related infections at a single Japanese center.

Methods:A total of 107 patients who underwent transvenous lead extraction were retrospectively reviewed. The patients were divided into a lead-related infective endocarditis group (n = 32) and a pocket infection group (n = 75). Procedure success rate and prognosis after lead extraction were evaluated between the two groups.

Results:Procedure success rate was not significantly different between the groups. There were no deaths associated with the procedure or with infection. The survival rate was not significantly different at 1 year or at a median of 816 days (lead-related infective endocarditis vs pocket infection; 93.7% vs 94.7%, P = 1.000; 78.1% vs 81.3%, P = 0.791) Time to reimplantation and duration of hospital stay and antibiotics therapy were significantly longer for patients with lead-related infective endocarditis.

Conclusion:In this study, the prognosis for patients with lead-related infective endocarditis after transvenous lead extraction was favorable. Thus, extraction should be strongly recommended, even if the general condition of the patient is poor.
DOI 10.1002/joa3.12164
PMID 31410236