Management of pacemaker-dependent patients and follow-up
In patients without bacteremia who were pacemaker-dependent, contralateral implantation of a new CIED device was performed during the same procedure. In pacing-dependent patients with bacteremia or those considered at high risk of reinfection, contralateral implantation was performed once blood cultures were negative (with temporary pacing through a femoral or jugular temporary pacemaker). Antibiotics were given according to institutional protocols. The vast majority of patients had an initial follow-up six weeks after the procedure, but the long-term follow-up (every six months) was performed only in those patients who had the device reimplanted. At each in-office follow-up, wound sites were examined, and patients were interrogated for symptoms of CIED infection and chlorhexidine-related adverse events. We used electronic medical records and phone calls to patients and their relatives to ensure data completion.