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

Nobuhiro Nishii, Yoshimasa Morimoto, Akihito Miyoshi, Saori Tsukuda, Masakazu Miyamoto, Satoshi Kawada, Koji Nakagawa, Atsuyuki Watanabe, Kazufumi Nakamura, Hiroshi Morita, Hiroshi Morimatsu, Nobuchika Kusano, Shingo Kasahara, Morio Shoda, Hiroshi Ito

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)654-663
Number of pages10
Journaljournal of arrhythmia
Volume35
Issue number4
DOIs
Publication statusPublished - Jan 1 2019

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Endocarditis
Equipment and Supplies
Infection
Lead
Replantation
Length of Stay
Survival Rate
Anti-Bacterial Agents
Mortality

Keywords

  • implantable cardioverter defibrillator
  • lead extraction
  • lead-related infective endocarditis
  • pacemaker
  • pocket infection

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{b9af06378f634e0bab63cb38994af5de,
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",
abstract = "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.",
keywords = "implantable cardioverter defibrillator, lead extraction, lead-related infective endocarditis, pacemaker, pocket infection",
author = "Nobuhiro Nishii and Yoshimasa Morimoto and Akihito Miyoshi and Saori Tsukuda and Masakazu Miyamoto and Satoshi Kawada and Koji Nakagawa and Atsuyuki Watanabe and Kazufumi Nakamura and Hiroshi Morita and Hiroshi Morimatsu and Nobuchika Kusano and Shingo Kasahara and Morio Shoda and Hiroshi Ito",
year = "2019",
month = "1",
day = "1",
doi = "10.1002/joa3.12164",
language = "English",
volume = "35",
pages = "654--663",
journal = "Journal of Arrhythmia",
issn = "1880-4276",
publisher = "Elsevier BV",
number = "4",

}

TY - JOUR

T1 - Prognosis after lead extraction in patients with cardiac implantable electronic devices infection

T2 - Comparison of lead-related infective endocarditis with pocket infection in a Japanese single-center experience

AU - Nishii, Nobuhiro

AU - Morimoto, Yoshimasa

AU - Miyoshi, Akihito

AU - Tsukuda, Saori

AU - Miyamoto, Masakazu

AU - Kawada, Satoshi

AU - Nakagawa, Koji

AU - Watanabe, Atsuyuki

AU - Nakamura, Kazufumi

AU - Morita, Hiroshi

AU - Morimatsu, Hiroshi

AU - Kusano, Nobuchika

AU - Kasahara, Shingo

AU - Shoda, Morio

AU - Ito, Hiroshi

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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.

AB - 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.

KW - implantable cardioverter defibrillator

KW - lead extraction

KW - lead-related infective endocarditis

KW - pacemaker

KW - pocket infection

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U2 - 10.1002/joa3.12164

DO - 10.1002/joa3.12164

M3 - Article

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JO - Journal of Arrhythmia

JF - Journal of Arrhythmia

SN - 1880-4276

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