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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