The wearable cardioverter defibrillator as a bridge to reimplantation in patients with ICD or CRT-D-related infections
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The wearable cardioverter defibrillator as a bridge to reimplantation in patients with ICD or CRT-D-related infections. / Castro, L; Pecha, S; Linder, M; Vogler, J; Gosau, N; Meyer, C; Willems, S; Reichenspurner, H; Hakmi, S.
in: J CARDIOTHORAC SURG, Jahrgang 12, Nr. 1, 25.11.2017, S. 99.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - The wearable cardioverter defibrillator as a bridge to reimplantation in patients with ICD or CRT-D-related infections
AU - Castro, L
AU - Pecha, S
AU - Linder, M
AU - Vogler, J
AU - Gosau, N
AU - Meyer, C
AU - Willems, S
AU - Reichenspurner, H
AU - Hakmi, S
PY - 2017/11/25
Y1 - 2017/11/25
N2 - 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.
AB - 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.
KW - Aged
KW - Anti-Bacterial Agents/therapeutic use
KW - Death, Sudden, Cardiac/prevention & control
KW - Defibrillators, Implantable
KW - Device Removal
KW - Electric Countershock/instrumentation
KW - Electrocardiography
KW - Female
KW - Germany/epidemiology
KW - Humans
KW - Incidence
KW - Male
KW - Prosthesis-Related Infections/epidemiology
KW - Replantation
KW - Retrospective Studies
KW - Survival Rate/trends
KW - Tachycardia, Ventricular/physiopathology
U2 - 10.1186/s13019-017-0669-2
DO - 10.1186/s13019-017-0669-2
M3 - SCORING: Journal article
C2 - 29178898
VL - 12
SP - 99
JO - J CARDIOTHORAC SURG
JF - J CARDIOTHORAC SURG
SN - 1749-8090
IS - 1
ER -