Key result
Repositioning a remnant intravascular electrode between the pectoralis major and minor muscles prevented the recurrence of cardioverter-defibrillator infection for 12 months in a patient who refused surgical removal.
Case Report (n=1)
No
Burying a remnant ICD electrode between pectoral muscles after generator removal and local infection control may be a viable salvage strategy for localized CIED infection when complete extraction is refused or impossible.
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May offer salvage for localized CIED infection when extraction refused; leaves open need for prospective validation.
Treatments of choice for cardiac implantable electronic device (CIED) infections are the removal of the entire CIED system, control of infection, and new device implantation. Occasionally, a complete CIED removal can not be performed for several reasons, such as very old age, severe comobidity, limited life expectancy, or refusal by a patient. We encountered a male patient who developed traumatic CIED infection five years after cardioverter-defibrillator implantation. An intravenous electrode could not be removed by a simple transvenous extraction procedure, and he refused surgical removal of the remnant electrode. After control of local infection, the tips of the electrode were separated and buried between muscles, and the wound was closed with a local flap. CIED infection did not recur for 12 months even without relying on long-term antimicrobial treatment.
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Hahn et al. (2011) conducted a case report in Cardioverter-Defibrillator Infection (n=1). Repositioning of remnant electrode between pectoralis muscles was evaluated on Recurrence of CIED infection. Repositioning a remnant intravascular electrode between the pectoralis major and minor muscles prevented the recurrence of cardioverter-defibrillator infection for 12 months in a patient who refused surgical removal.
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