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Management of a Remnant Electrode in a Patient With Cardioverter-Defibrillator Infection After Refusal of Intravascular Electrode Removal

  • Hahn, Sung-Hwahn (Division of Cardiology, Department of Internal Medicine, School of Medicine, Dankook University) ;
  • Kim, Ji-Hwan (Division of Cardiology, Department of Internal Medicine, School of Medicine, Dankook University) ;
  • Choi, Jung-Hyun (Division of Cardiology, Department of Internal Medicine, School of Medicine, Dankook University) ;
  • Lim, Seong-Hoon (Division of Cardiology, Department of Internal Medicine, School of Medicine, Dankook University) ;
  • Kang, Tae-Soo (Division of Cardiology, Department of Internal Medicine, School of Medicine, Dankook University) ;
  • Park, Byoung-Eun (Division of Cardiology, Department of Internal Medicine, School of Medicine, Dankook University) ;
  • Lee, Myung-Yong (Division of Cardiology, Department of Internal Medicine, School of Medicine, Dankook University)
  • 발행 : 2011.01.30

초록

Treatments of choice for cardiac implantable electronic device (CIED) infections are the removal of the entire CIED system, control of infection, and new device implantation. Occasionally, a complete CIED removal can not be performed for several reasons, such as very old age, severe comobidity, limited life expectancy, or refusal by a patient. We encountered a male patient who developed traumatic CIED infection five years after cardioverter-defibrillator implantation. An intravenous electrode could not be removed by a simple transvenous extraction procedure, and he refused surgical removal of the remnant electrode. After control of local infection, the tips of the electrode were separated and buried between muscles, and the wound was closed with a local flap. CIED infection did not recur for 12 months even without relying on long-term antimicrobial treatment.

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참고문헌

  1. Chua JD, Wilkoff BL, Lee I, Juratli N, Longworth DL, Gordon SM. Diagnosis and management of infections involving implantable electrophysiologic cardiac devices. Ann Intern Med 2000;133:604-8. https://doi.org/10.7326/0003-4819-133-8-200010170-00011
  2. Sohail MR, Uslan DZ, Kahn AH, et al. Management and outcome of permanent and implantable cardioverter-defibrillator infections. J Am Coll Cardiol 2007;49:1851-9. https://doi.org/10.1016/j.jacc.2007.01.072
  3. Love CJ, Wilkoff BL, Byrd CL, et al. Recommendations for extraction of chronically implanted transvenous pacing and defibrillator leads; in-dications, facilities, training. Pacing Clin Electrophysiol 2000;23: 544-51. https://doi.org/10.1111/j.1540-8159.2000.tb00845.x
  4. Baddour LM, Bettmann MA, Bolger AF, et al. Nonvalvular cardiovascular device-related infections. Circulation 2003;108:2015-31. https://doi.org/10.1161/01.CIR.0000093201.57771.47
  5. Gaynor SL, Zierer A, Lawton JS, Gleva MJ, Damiano RJ Jr, Moon MR. Laser assistance for extraction of chronically implanted endocardial leads: infectious versus noninfectious indications. Pacing Clin Electrophysiol 2006;29:1352-8. https://doi.org/10.1111/j.1540-8159.2006.00547.x
  6. Field ME, Jones SO, Epstein LM. How to select patients for lead extraction. Heart Rhythm 2007;4:978-85. https://doi.org/10.1016/j.hrthm.2007.05.022
  7. Chua JD, Wilkoff BL, Lee I, et al. Diagnosis and management of infections involving implantable electrophysiologic cardiac devices. Ann Intern Med 2000;133:604-8. https://doi.org/10.7326/0003-4819-133-8-200010170-00011
  8. Sopena B, Crespo M, Beiras X, et al. Individualized management of bacteraemia in patients with a permanent endocardial pacemaker. Clin Microbiol Infect 2010;16:274-80. https://doi.org/10.1111/j.1469-0691.2009.02787.x
  9. Baddour LM. Long-term suppressive antimicrobial therapy for intravascular device-related infections. Am J Med Sci 2001;322:209-12. https://doi.org/10.1097/00000441-200110000-00011
  10. Baddour LM, Epstein AE, Erickson CC, et al. Update on cardiovascular implantable electronic device infections and their management: a scientific statement from the American Heart Association. Circulation 2010;121:458-77. https://doi.org/10.1161/CIRCULATIONAHA.109.192665
  11. Trappe HJ, Pfitzner P, Klein H, Wenzlaff P. Infections after cardioverter-defibrillator implantation: observations in 335 patients over 10 years. Br Heart J 1995;73:20-4. https://doi.org/10.1136/hrt.73.1.20
  12. Lai KK, Fontecchio SA. Infections associated with implantable cardioverter-defibrillators placed transvenously and via thoracotomies: epidemiology, infection control, and management. Clin Infect Dis 1998; 27:265-9. https://doi.org/10.1086/514673
  13. Gould PA, Krahn AD; Canadian Heart Rhythm Society Working Group on Device Advisories. Complications associated with implantable cardioverter-defibrillator replacement in response to device advisories. JAMA 2006;295:1907-11. https://doi.org/10.1001/jama.295.16.1907
  14. O'Nunain S, Perez I, Roelke M, et al. The treatment of patients with infected implantable cardioverter-defibrillator systems. J Thorac Cardiovasc Surg 1997;113:121-9. https://doi.org/10.1016/S0022-5223(97)70407-0
  15. Sohail MR, Uslan DZ, Kahn AH, et al. Infective endocarditis complicating permanent pacemaker and implantable cardioverter-defibrillator infection. Mayo Clin Proc 2008;83:46-53. https://doi.org/10.4065/83.1.46
  16. Baman TS, Gupta SK, Valle JA, Yamata E. Risk factors for mortality in patients with cardiac device-related infection. Circ Arrhythm Electrophysiol 2009;2:129-34. https://doi.org/10.1161/CIRCEP.108.816868
  17. de Oliveira JC, Martinelli M, Nishioka SA, et al. Efficacy of antibiotic prophylaxis before the implantation of pacemakers and cardioverter-defibrillators: results of a large, prospective, randomized, double-blinded, placebo-controlled trial. Circ Arrhythm Electrophysiol 2009;2:29-34. https://doi.org/10.1161/CIRCEP.108.795906
  18. Lekkerkerker JC, van Nieuwkoop C, Trines SA, et al. Risk factors and time delay associated with cardiac device infections: Leiden device registry. Heart 2009;95:715-20. https://doi.org/10.1136/hrt.2008.151985
  19. Bloom H, Heeke B, Leon A, et al. Renal insufficiency and the risk of infection from pacemaker or defibrillator surgery. Pacing Clin Electrophysiol 2006;29:142-5. https://doi.org/10.1111/j.1540-8159.2006.00307.x
  20. Sohail MR, Uslan DZ, Khan AH, et al. Risk factor analysis of permanent pacemaker infection. Clin Infect Dis 2007;45:166-73. https://doi.org/10.1086/518889
  21. Klug D, Balde M, Pavin D, et al. Risk factor related to infections of implanted pacemakers and cardioverter-defibrillators: results of a large prospective study. Circulation 2007;116:1349-55. https://doi.org/10.1161/CIRCULATIONAHA.106.678664
  22. Da Costa A, Kirkorian G, Cucherat M, et al. Antibiotic prophylaxis for permanent pacemaker implantation: a meta-analysis. Circulation 1998;97:1796-801. https://doi.org/10.1161/01.CIR.97.18.1796
  23. Al-Khatib SM, Lucas FL, Jollis JG, Malenka DJ, Wennberg DE. The relation between patients' outcome and the volume of cardioverter-defibrillator implantation procedures performed by physicians treating Medicare beneficiary. J Am Coll Cardiol 2005;46:1536-40. https://doi.org/10.1016/j.jacc.2005.04.063
  24. Chamis AL, Perteson GE, Cabell CH, et al. Staphylococcus aureus bateremia in patients with permanent pacemakers or implantable cardioverter-defibrillators. Circulation 2001;104:1029-33. https://doi.org/10.1161/hc3401.095097
  25. Kapa S, Hyberger L, Rea RF, Hayes DL. Complication risk with pulse generator change: implications when reacting to a device advisory or recall. Pacing Clin Electrophysiol 2007;30:730-3. https://doi.org/10.1111/j.1540-8159.2007.00742.x
  26. Choi HS, Rhee MY, Choi YJ, et al. Long-term follow-up of the patients with permanent antibradycardia pacemaker. Korean Circ J 1998; 28:768-73. https://doi.org/10.4070/kcj.1998.28.5.768
  27. Choi KJ, Lee CW, Kim JJ, Kim YH. Implantable cardioverter-defibrillator (ICD) therapy in a patient with the long QT syndrome. Korean Circ J 1996;26:1198-203.
  28. Kim DH, Kim SY, Lee KH, et al. Follow-up of a group of patients with automatic implantable defibrillator. Korean Circ J 2005;35:69-83.