Dell'Era Gabriele, Ziacchi Matteo, Prenna Eleonora, Diemberger Igor, Varalda Marco, Martignani Cristian, Guerra Federico, Biffi Mauro, Occhetta Eraldo
Division of Cardiology, University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy.
Institute of Cardiology, University of Bologna, S. Orsola-Malpighi University Hospital, Bologna, Italy.
Pacing Clin Electrophysiol. 2018 May;41(5):532-535. doi: 10.1111/pace.13320. Epub 2018 Apr 15.
The management of patients explanted for implantable converter defibrillator (ICD) infections may be complex when anti-bradycardia pacing and tachyarrhythmia protection are needed. We aimed to test the efficacy and safety of a conventional ICD externally connected to a transvenous dual-coil lead as bridging therapy before the reimplantation.
We enrolled seven patients explanted for ICD infections and needed prolonged antibiotic therapy in two high-volume hospitals in Italy and treated them with a passive-can external ICD for a mean of 13 (4-30) days before reimplant. One patient experienced an electrical storm, efficaciously recognized by the external ICD and treated with antitachycardia pacing and shocks. On-demand pacing was granted for all the patients. No device-related complications were reported.
An external ICD seems safe and efficacious as a bridge to reimplant in patients explanted for ICD infections.
当需要抗心动过缓起搏和预防快速性心律失常时，因植入式心律转复除颤器（ICD）感染而取出装置的患者的管理可能较为复杂。我们旨在测试在重新植入前，将传统ICD通过静脉双线圈导线进行外部连接作为桥接治疗的有效性和安全性。
我们在意大利的两家大型医院招募了7例因ICD感染而取出装置且需要长期抗生素治疗的患者，并在重新植入前用被动式体外ICD对他们进行了平均13（4 - 30）天的治疗。1例患者发生电风暴，被体外ICD有效识别，并通过抗心动过速起搏和电击进行治疗。所有患者均获得按需起搏。未报告与装置相关的并发症。
对于因ICD感染而取出装置的患者，体外ICD作为重新植入的桥接治疗似乎是安全有效的。
