Bertolino Lorenzo, Florio Letizia Lucia, Patauner Fabian, Gallo Raffaella, Peluso Anna Maria, Scafuri Antonio, De Vivo Stefano, Corrado Carmelina, Zampino Rosa, Ruocco Giuseppe, D'Onofrio Antonio, Durante-Mangoni Emanuele
Department of Precision Medicine, University of Campania 'L. Vanvitelli', Via de Crecchio, 7, 80138 Napoli, Italy.
Department of Advanced Medical & Surgical Sciences, University of Campania 'L. Vanvitelli', Piazza Luigi Miraglia, 2, 80138 Napoli, Italy.
J Clin Med. 2023 Dec 8;12(24):7573. doi: 10.3390/jcm12247573.
(1) Background: Leadless pacemakers (LPs) have been proposed as a reimplantation strategy in pacing-dependent patients undergoing cardiac implantable electronic device (CIED) extraction for infection. In this study, we analysed the risk of LP infection when this device is implanted before lead extraction. (2) Methods: This was a retrospective study including patients who underwent LP implantation between 2017 and 2022. Patients were divided in two groups according to whether LP was implanted following CIED extraction for infection (Group 1) or other indications (Group 2). The primary aim was to describe the risk of LP infection. (3) Results: We included in this study 49 patients with a median age of 81 [20-94] years, mostly males (36, 73%). In Group 1 patients, 17 cases (85%) showed systemic CIED infections, and 11 (55%) had positive lead cultures. Most Group 1 cases (n = 14, 70%) underwent one stage of LP implantation and CIED extraction. Mortality rate during follow-up was 20% (nine patients). Patients were followed up for a median of 927 [41-1925], days and no cases of definite or suspected LP infections were identified. (4) Conclusions: The risk of LP infection was extremely low. LP appears as a potential option for reimplantation in this setting and should be considered in pacing-dependent patients at a high risk of CIED infection recurrence.
（1）背景：对于因感染而接受心脏植入式电子设备（CIED）拔除的起搏依赖患者，无导线起搏器（LPs）已被提议作为一种重新植入策略。在本研究中，我们分析了在拔除导线之前植入该设备时LPs感染的风险。（2）方法：这是一项回顾性研究，纳入了2017年至2022年间接受LPs植入的患者。根据LPs是在因感染而拔除CIED后植入（第1组）还是因其他指征植入（第2组），将患者分为两组。主要目的是描述LPs感染的风险。（3）结果：本研究纳入了49例患者，中位年龄为81[20 - 94]岁，大多数为男性（36例，73%）。在第1组患者中，17例（85%）表现为全身性CIED感染，11例（55%）导线培养呈阳性。第1组的大多数病例（n = 14，70%）接受了一期LPs植入和CIED拔除。随访期间的死亡率为20%（9例患者）。患者的中位随访时间为927[41 - 1925]天，未发现明确或疑似LPs感染病例。（4）结论：LPs感染的风险极低。在这种情况下，LPs似乎是一种潜在的重新植入选择，对于CIED感染复发风险高的起搏依赖患者应予以考虑。
