Key result
In two elderly patients with pacemaker infections, device explantation without immediate reimplantation was successful, as continuous monitoring revealed no symptomatic bradycardia necessitating a new device.
Case Report (n=2)
In some patients presenting with CIED infection, the initial indication for pacing may have resolved, obviating the need for device reimplantation and thereby reducing the risk of recurrent infection and associated costs.
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May support selective non-reimplantation after CIED infection in elderly patients; hypothesis-generating and requires prospective validation.
There has been an increase in number of cardiac implantable electronic devices (CIEDs) implantation and with this we have witnessed increased rates of CIED infection mainly in elderly population. It is important to assess conditions that may not reliably improve with cardiac pacing or those who lack adequate beneficial effect from permanent pacing before contemplating implantation or reimplantation of these devices. Sometimes, the initial cardiac pathology may revert obviating the need for reimplantation as in the two cases that we have discussed below. This reduces the chance of further infection of CIED, and decreases mortality and morbidity due to recurrent CIED infection and decreases cost of care.
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Sharma et al. (2018) conducted a case report in Cardiac implantable electronic device (CIED) infection (n=2). Device explantation without immediate reimplantation was evaluated on Need for permanent pacemaker reimplantation. In two elderly patients with pacemaker infections, device explantation without immediate reimplantation was successful, as continuous monitoring revealed no symptomatic bradycardia necessitating a new device.
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