Author + information
- Eric Black-Maier,
- Sean Pokorney,
- Alexander Christian,
- Robert K. Lewis,
- Ruth Ann Greenfield,
- Donald Hegland,
- James Daubert and
- Jonathan Piccini
The incidence of cardiovascular implantable electronic device (CIED) infection is increasing. Few reports explore characteristics and outcomes of extraction for infection versus non-infection indications.
Methods and Results
Using a cohort of 368 patients undergoing lead extraction (dwell time >1 yrear) between 2005-2012. We compared patient characteristics/outcomes based upon the underlying indications for extraction (3 groups): no infection (NI, n=153), pocket infection (PI, n=126), and bacteremia and endocarditis (BE, n=86). Patients with infections were older with a median age of 57, 71, and 63 years for NI, PI, and BE respectively (p<0.0001). Comorbid illness was much more common in those with PI and most prevalent in those with BE, including diabetes, hypertension, chronic kidney disease, and end-stage renal disease (Figure). There was a trend to longer implant times in the non-infection NI group: median 4.2, 5.7, and 4.5 years, for NI, PI, and BE respectively, p=0.07). Extraction for infectious etiologies had a higher extraction-related major adverse event rates MAE relative to NI (BE=5%, PI=9%, and NI= 2.0%, p=0.034). In-hospital mortality was statistically similar between the categorizations but tended to be higher in the infectious groups (Figure).
Patients who present for lead extraction due to local or systemic infection have higher comorbid illness and experience more adverse events. Patients with infection represent a particularly high-risk group.
Poster Area, South Hall A1
Monday, April 04, 2016, 9:45 a.m.-10:30 a.m.
Session Title: Clinical Care of Patients With Implanted Devices
Abstract Category: 18. Arrhythmias and Clinical EP: Devices
Presentation Number: 1266-331
- 2016 American College of Cardiology Foundation