Introduction
The incidence of pacemaker (PM) infections among patients with an
advanced age has been increasing owing to the continually widening
indications and growing number of generator replacements.1-3 In current clinical practice, there is a class l
indication for removing all hardware in the case of a proven or
suspected device infection, and after a recovery window, a new
conventional PM is implanted for PM dependent patients.1, 4, 5 However, these managements for the elderly
population are one of the most sensitive issues, since they possess
particular clinical challenges due to higher rates of concurrent
cardiovascular disease and medical comorbidities. 6-10
Recently, the implantation of a Micra Transcatheter Pacing System
(Medtronic Inc, Minneapolis, MN) has emerged as a new option for PM
re-implantation after the removal of infectious PMs.11-17 Without the use of leads and a device pocket,
this leadless pacemaker (LP) potentially reduces the risk of a pocket
infection and leadāassociated endocarditis. However, there have been
only few data supporting the feasibility of leadless PM implantations
following the removal of infectious PMs in people with an older age,
particularly in octogenarians. Furthermore, there is a concern that
octogenarians are proposed as an important risk factor for perforations
during LP implantations. 12 Therefore, we sought to
investigate the feasibility and outcome of an LP implantation following
a transvenous lead extraction (TLE) of an infected PM in octogenarians.