Efficacy and safety of negative pressure wound therapy in the treatment of patients with cardiovascular implantable electronic devices pocket infection.

OBJECTIVES

To evaluate the efficacy of negative-pressure wound therapy (NPWT) for cardiac implantable electronic device (CIED) pocket infection, eliminating the need for CIED and leads extraction.

METHODS

The NPWT cohort consisted of 42 patients with CIED infection who were treated with NPWT from 2013 to 2023. Among them, 3 patients had a systemic infection and 1 patient had incomplete data. We performed a case-control study in which the NPWT group was compared with the conservative treatment group (40 patients). Main outcomes included failure rate (CIED/lead extraction during the 1-year follow-up, 30-day mortality/chronic infection, or infection-related mortality/recurrence) and infection-free time, with cure defined as absence of failure criteria.

RESULTS

A total of 38 patients with pocket infections were treated with NPWT from 2013 to 2023. NPWT was curative in 78.9% (n = 30 of 38) of patients who remained free of infection [median follow-up 12.63 months, interquartile range (IQR): 12.30-34.10 months]. Compared with patients who were treated conservatively, the two groups demonstrated balanced baseline characteristics. Patients who were treated with NPWT had a significantly higher cure rate (78.9% vs. 55.0%, n = 22 of 40; p = 0.025) and a longer mean infection-free time at the 1-year follow-up (338.00 vs. 285.20 days, p = 0.034).

CONCLUSION

NPWT is an effective alternative for patients with CIED pocket infections who are unsuitable or unwilling to undergo CIED and leads extraction.

TRIAL REGISTRATION

This study was approved by the Chinese Clinical Trial Registry (Clinicaltrials.gov number: ChiCTR2300073560) on July 07, 2023.