Author + information
- Talha Riaz,
- Juhsien JC Nienaber,
- Larry M. Baddour,
- Randall C. Walker,
- Soon J. Park and
- Muhammad Sohail
Most patients with left ventricular assist devices (LVAD) also have concomitant cardiovascular implantable electronic devices (CIED). However, the clinical presentation and outcome of CIED infection in the setting of LVAD has not been previously described.
We retrospectively reviewed hospital records of 247 patients who underwent LVAD implantation at Mayo Clinic campuses in Minnesota, Arizona and Florida, from January 2005 to December 2011. Demographic and clinical data of patients that met criteria for CIED infection were extracted.
Of the 247 patients with LVADs, 215 (87%) had CIED at the time of LVAD implantation and six (2.79%) subsequently developed CIED infections. The median age of these 6 patients was 65 years (35-72 years). Three patients developed CIED lead-related endocarditis and the other three had pocket infection. All three instances of CIED pocket infection were preceded by device generator exchange, while all three patients with CIED lead-related endocarditis had prior LVAD-related infections. The causative pathogens included Pseudomonas aeruginosa (1), coagulase-negative staphylococci (2), methicillin-resistant Staphylococcus aureus (1), a gram-positive bacillus not further identified (1), and culture-negative (2). All patients underwent complete CIED removal along with antimicrobial therapy. The three patients with CIED lead vegetations and prior LVAD infections received chronic suppressive antibiotic therapy, and one patient also had LVAD exchange. All but one remained alive at the last follow-up with a median duration of 15 months (7-46 months) from the time of CIED infection.
Although the number of CIED infection cases is small in this investigation, the presentations of CIED infection are consistent with what has been described regarding risk factors in both pocket infections and lead-related endocarditis.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Arrhythmias: Devices I – Identification and Avoidance of Complications Associated with Implantable Devices
Abstract Category: 8. Arrhythmias: Devices
Presentation Number: 1149-33
- 2013 American College of Cardiology Foundation