Key result
Single-procedure CIED extraction and reimplantation is linked to similar 12-month survival versus two-stage replacement.
Why the study?
Infections are among the most frequent and life-threatening complications of CIED implantation, prompting a comparison between single-procedure extraction with contralateral implantation and standard-of-care two-stage replacement.
Does single-procedure device extraction and contralateral implantation improve survival compared to standard-of-care two-stage replacement in patients with CIED infections?
Observational (n=66)
Yes
Does single-procedure device extraction and contralateral implantation improve survival compared to standard-of-care two-stage replacement in patients with CIED infections?
Absolute Event Rate: 81.5% vs 84.6%
p-value: p=0.075
A single-procedure extraction and reimplantation strategy for infected CIEDs showed comparable 12-month survival to standard two-stage replacement, suggesting it may be a feasible alternative.
Single-procedure extraction/reimplantation may be feasible for infected CIEDs; leaves open whether it matches two-stage outcomes in randomized trials.
(1) Background: Infections are among the most frequent and life-threatening complications of cardiovascular implantable electronic device (CIED) implantation. The aim of this study is to compare the outcome and safety of a single-procedure device extraction and contralateral implantation versus the standard-of-care (SoC) two-stage replacement for infected CIEDs. (2) Methods: We retrospectively included 66 patients with CIED infections who were treated at two Italian hospitals. Of the 66 patients enrolled in the study, 27 underwent a single procedure, whereas 39 received SoC treatment. All patients were followed up for 12 months after the procedure. (3) Results: Considering those lost to follow-up, there were no differences in the mortality rates between the two cohorts, with survival rates of 81.5% in the single-procedure group and 84.6% in the SoC group (p = 0.075). (4) Conclusions: Single-procedure reimplantation associated with an active antibiofilm therapy may be a feasible and effective therapeutic option in CIED-dependent and frail patients. Further studies are warranted to define the best treatment regimen and strategies to select patients suitable for the single-procedure reimplantation.
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Tascini et al. (2023) conducted an observational in Cardiovascular implantable electronic device (CIED) infections (n=66). Single-procedure device extraction and contralateral implantation vs. Standard-of-care (SoC) two-stage replacement was evaluated on Survival rate (p=0.075). Single-procedure device extraction and reimplantation yielded similar 12-month survival rates compared to standard two-stage replacement for infected CIEDs (81.5% vs 84.6%; p=0.075).
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