Cardiovascular Implantable Electronic Devices -> Leads & Electrodes: -> Extraction/Removal D-MP05 - Lead Extraction and CIED Infection - Risk Management (ID 9) Moderated ePoster

D-MP05-04 - Recurrent Infection Of Cardiovascular Implantable Electronic Devices Following Device Extraction And Reimplantation (ID 1381)

Disclosure
 A. Lin: Nothing relevant to disclose.

Abstract

Background: Cardiovascular implantable electronic device (CIED) infections are associated with high morbidity and mortality. The prevalence, risk factor, and procedural outcome of patients with recurrent CIED infection after prior extraction and re-implant has not been well-characterized.
Objective: To determine the incidence and risk factors for recurrent CIED infection requiring device extraction.
Methods: All infected CIED extraction cases at UC San Diego from 2011 to 2019 were reviewed. Patients who underwent CIED re-implant according to standard protocol and infectious disease consultation were divided into two groups based on recurrence of infection requiring repeat CIED extraction. We assessed the incidence and risk factors for recurrent CIED infection and compared the procedural outcomes of the first and second extraction cases.
Results: Of 207 patients who underwent CIED extraction, 61 patients underwent CIED re-implant at our institution, 7 of whom had recurrent CIED infection requiring repeat device extraction. Baseline characteristics were similar between the two groups (Figure 1). Mean time to recurrent CIED infection was 175 ± 135 days. End stage renal disease is associated with increased risk of recurrent CIED infection (OR 10.4, 95% CI 1.2 - 90.5, p = 0.03). Procedural time was shorter for the second extraction (71 ± 8 vs 133 ± 20 minutes, p = 0.03) with no difference in complication rate.
Conclusion: Recurrent CIED infection is overall uncommon. However, patients with end stage renal disease are at increased risk for recurrent infection. Further efforts are warranted to address lead management in this high-risk cohort.
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