Abbreviations: CIED- cardiac implantable electronic device, CRT- cardiac
resynchronization therapy, ICD- implantable cardioverter defibrillator,
LRIE- lead related infective endocarditis, TLE- transvenous lead
extraction, WBC- white blood count
Current analysis of a very large database of patients undergoing TLE
confirmed the clinical importance of thinning of the CIED pocket in the
development of infectious complications.
Patients with pocket infections (with or without lead-related
endocarditis) were more often undergoing surgical plastic surgery before
TLE (27%). This clearly indicates that previously recognized only too
shallow CIED pockets were already an early symptom of an infection
which, despite the deepening of the pocket, developed into a full-blown
infection after some time. Despite the fact that in the group of
patients with a shallow pocket of the CIED, only 60% of patients had an
infection, the highest values of the PADIT score were recorded in this
group of patients. These observations suggest the possibility of an
earlier development of microorganisms in a too shallow pockets. Previous
studies based on small populations confirm the presence of early
contamination of the pocket with a tendency to subsequent colonization
and development of full-blown infection. It seems that in patients with
a shallow pocket, the infectious process may begin early after
implantation and proceed covertly, therefore, presented by Yatomi et al.
the concept of measuring skin thinning over the generator can be a form
of detailed control of patients particularly at risk of developing
infectious complications..
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