Department School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine Position Endowed Professor
|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.
|Formal name：Journal of arrhythmia
|Domestic / Foregin
|Japanese Heart Rhythm Society
|Volume, Issue, Page
|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
|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.