We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Salvage of Infected ICDs: Management Without Removal.
- Authors
Lee, Jai H.; Geha, Alexander S.; Rattehalli, N. Murthy; Cmolik, Brian L.; Johnson, Nancy J.; Biblo, Lee A.; Carlson, Mark D.; Waldo, Albert L.
- Abstract
During the 7-year period from August 1986 to December 1993, 242 patients with malignant ventricular arrhythmias underwent 242 ICD implantations and 50 subcutaneous generator changes. Wound infections developed in 5 patients (1.7%): in 3 cases, after primary implantation (3/242 [1.2%]); and in 2 following a generator change (2/50 [4.0%]). This difference was not statistically significant. Infection developed at the generator pocket and became clinically manifest between 6 weeks and 40 months, postoperatively. Our treatment approach with the first patient consisted of simple debridement of the pocket and reimplantation of the existing generator. This led to recurrence, and the generator was safely explanted. In the remaining four patients, our approach has been that of local treatment, with wide debridement of the pocket, and placement of a closed irrigation system with continuous irrigation with a bacitracin, polymyxin, neomycin solution, and culture- specific antibiotic therapy. We have successfully controlled the infection and salvaged the generator with this approach in all four patients, who are all alive and well at a mean follow-up of 25.0 ± 17.3 months with no recurrence. The good results obtained in these patients suggest that the concept of total explantation of the infected ICD should be reassessed.
- Subjects
DEFIBRILLATORS; ELECTRONICS in cardiology; ARRHYTHMIA; WOUND care; HEART diseases; CARDIAC pacing
- Publication
Pacing & Clinical Electrophysiology, 1996, Vol 19, Issue 4, p437
- ISSN
0147-8389
- Publication type
Article
- DOI
10.1111/j.1540-8159.1996.tb06514.x