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Maille B, Behar N, Jacon P, Hourdain J, Franceschi F, Koutbi L, Tovmassian L, Bierme C, Seder E, Klein V, Postzich M, Resseguier N, Leclerq C, Defaye P, Deharo JC. Two-in-one procedure for transvenous lead extraction and leadless pacemaker reimplantation in pacemaker-dependent patients with device infection: streamlined patient flow. Europace 2024; 26:euae162. [PMID: 39031020 PMCID: PMC11259849 DOI: 10.1093/europace/euae162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 05/27/2024] [Indexed: 07/22/2024] Open
Affiliation(s)
- Baptiste Maille
- Department of Cardiology, Timone University Hospital, 264 rue Saint-Pierre, 13005 Marseille, France
| | - Nathalie Behar
- Department of Cardiology and Vascular Disease Division, Rennes University Hospital, Rennes, France
| | - Peggy Jacon
- Department of Cardiology, CHU Grenoble Alpes, Grenoble, France
| | - Jerome Hourdain
- Department of Cardiology, Timone University Hospital, 264 rue Saint-Pierre, 13005 Marseille, France
| | - Frederic Franceschi
- Department of Cardiology, Timone University Hospital, 264 rue Saint-Pierre, 13005 Marseille, France
| | - Linda Koutbi
- Department of Cardiology, Timone University Hospital, 264 rue Saint-Pierre, 13005 Marseille, France
| | - Lilith Tovmassian
- Department of Cardiology, Timone University Hospital, 264 rue Saint-Pierre, 13005 Marseille, France
| | - Cédric Bierme
- Department of Cardiology, Timone University Hospital, 264 rue Saint-Pierre, 13005 Marseille, France
| | - Elena Seder
- Department of Cardiology, Timone University Hospital, 264 rue Saint-Pierre, 13005 Marseille, France
| | - Victor Klein
- Department of Cardiology, Timone University Hospital, 264 rue Saint-Pierre, 13005 Marseille, France
| | - Martin Postzich
- CEReSS-Health Service Research and Quality of Life Center, School of Medicine, Aix-Marseille University, Marseille, France
| | - Noemie Resseguier
- CEReSS-Health Service Research and Quality of Life Center, School of Medicine, Aix-Marseille University, Marseille, France
| | - Christophe Leclerq
- Department of Cardiology and Vascular Disease Division, Rennes University Hospital, Rennes, France
| | - Pascal Defaye
- Department of Cardiology, CHU Grenoble Alpes, Grenoble, France
| | - Jean-Claude Deharo
- Department of Cardiology, Timone University Hospital, 264 rue Saint-Pierre, 13005 Marseille, France
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Patsiou V, Haidich AB, Baroutidou A, Giannopoulos A, Giannakoulas G. Epicardial Versus Endocardial Pacing in Paediatric Patients with Atrioventricular Block or Sinus Node Dysfunction: A Systematic Review and Meta-analysis. Pediatr Cardiol 2023; 44:1641-1648. [PMID: 37480376 PMCID: PMC10520152 DOI: 10.1007/s00246-023-03213-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 06/14/2023] [Indexed: 07/24/2023]
Abstract
Pacing indications in children are clearly defined, but whether an epicardial (EPI) or an endocardial (ENDO) pacemaker performs better remains to be elucidated. This systematic review and meta-analysis aimed to directly compare the incidence of pacemaker (PM) lead-related complications, mortality, hemothorax and venous occlusion between EPI and ENDO in children with atrioventricular block (AVB) or sinus node dysfunction (SND). Literature search was conducted in MEDLINE (via PubMed), Scopus by ELSEVIER, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and OpenGrey databases until June 25, 2022. Random-effects meta-analyses were performed to assess the pacing method's effect on lead failure, threshold rise, post-implantation infection and battery depletion and secondarily on all-cause mortality, hemothorax and venous occlusion. Several sensitivity analyses were also performed. Of 22 studies initially retrieved, 18 were deemed eligible for systematic review and 15 for meta-analysis. Of 1348 pediatric patients that underwent EPI or ENDO implantation, 542 (40.2%) had a diagnosis of congenital heart disease (CHD). EPI was significantly associated with higher possibility of PM-lead failure [pooled odds ratio (pOR) 3.00, 95% confidence interval (CI) 2.05-4.39; I2 = 0%]; while possibility for threshold rise, post-implantation infection and battery depletion did not differ between the PM types. Regarding the secondary outcome, the mortality rates between EPI and ENDO did not differ. In sensitivity analyses the results were consistent results between the two PM types. The findings suggest that EPI may be associated with increased PM-lead failure compared to ENDO while threshold rise, infection, battery depletion and mortality rates did not differ.
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Affiliation(s)
- Vasiliki Patsiou
- First Department of Cardiology, AHEPA University Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anna-Bettina Haidich
- Department of Hygiene, Social-Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece.
| | - Amalia Baroutidou
- First Department of Cardiology, AHEPA University Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andreas Giannopoulos
- Second Department of Pediatrics, AHEPA University Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - George Giannakoulas
- First Department of Cardiology, AHEPA University Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Delgado V, Ajmone Marsan N, de Waha S, Bonaros N, Brida M, Burri H, Caselli S, Doenst T, Ederhy S, Erba PA, Foldager D, Fosbøl EL, Kovac J, Mestres CA, Miller OI, Miro JM, Pazdernik M, Pizzi MN, Quintana E, Rasmussen TB, Ristić AD, Rodés-Cabau J, Sionis A, Zühlke LJ, Borger MA. 2023 ESC Guidelines for the management of endocarditis. Eur Heart J 2023; 44:3948-4042. [PMID: 37622656 DOI: 10.1093/eurheartj/ehad193] [Citation(s) in RCA: 242] [Impact Index Per Article: 242.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/26/2023] Open
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Cimmino G, Bottino R, Formisano T, Orlandi M, Molinari D, Sperlongano S, Castaldo P, D’Elia S, Carbone A, Palladino A, Forte L, Coppolino F, Torella M, Coppola N. Current Views on Infective Endocarditis: Changing Epidemiology, Improving Diagnostic Tools and Centering the Patient for Up-to-Date Management. Life (Basel) 2023; 13:life13020377. [PMID: 36836734 PMCID: PMC9965398 DOI: 10.3390/life13020377] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/08/2023] [Accepted: 01/23/2023] [Indexed: 01/31/2023] Open
Abstract
Infective endocarditis (IE) is a rare but potentially life-threatening disease, sometimes with longstanding sequels among surviving patients. The population at high risk of IE is represented by patients with underlying structural heart disease and/or intravascular prosthetic material. Taking into account the increasing number of intravascular and intracardiac procedures associated with device implantation, the number of patients at risk is growing too. If bacteremia develops, infected vegetation on the native/prosthetic valve or any intracardiac/intravascular device may occur as the final result of invading microorganisms/host immune system interaction. In the case of IE suspicion, all efforts must be focused on the diagnosis as IE can spread to almost any organ in the body. Unfortunately, the diagnosis of IE might be difficult and require a combination of clinical examination, microbiological assessment and echocardiographic evaluation. There is a need of novel microbiological and imaging techniques, especially in cases of blood culture-negative. In the last few years, the management of IE has changed. A multidisciplinary care team, including experts in infectious diseases, cardiology and cardiac surgery, namely, the Endocarditis Team, is highly recommended by the current guidelines.
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Affiliation(s)
- Giovanni Cimmino
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
- Correspondence: or ; Tel.: +39-0815664141
| | - Roberta Bottino
- Cardiology Unit, Azienda Ospedaliera Universitaria Luigi Vanvitelli, 80138 Napoli, Italy
| | - Tiziana Formisano
- Cardiology Unit, Azienda Ospedaliera Universitaria Luigi Vanvitelli, 80138 Napoli, Italy
| | - Massimiliano Orlandi
- Cardiology Unit, Azienda Ospedaliera Universitaria Luigi Vanvitelli, 80138 Napoli, Italy
| | - Daniele Molinari
- Cardiology Unit, Azienda Ospedaliera Universitaria Luigi Vanvitelli, 80138 Napoli, Italy
| | - Simona Sperlongano
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Pasquale Castaldo
- Cardiology Unit, Azienda Ospedaliera Universitaria Luigi Vanvitelli, 80138 Napoli, Italy
| | - Saverio D’Elia
- Cardiology Unit, Azienda Ospedaliera Universitaria Luigi Vanvitelli, 80138 Napoli, Italy
| | - Andreina Carbone
- Cardiology Unit, Azienda Ospedaliera Universitaria Luigi Vanvitelli, 80138 Napoli, Italy
| | - Alberto Palladino
- Cardiology Unit, Azienda Ospedaliera Universitaria Luigi Vanvitelli, 80138 Napoli, Italy
| | - Lavinia Forte
- Cardiology Unit, Azienda Ospedaliera Universitaria Luigi Vanvitelli, 80138 Napoli, Italy
| | - Francesco Coppolino
- Department of Women, Child and General and Specialized Surgery, Section of Anaesthesiology, University of Campania Luigi Vanvitelli, Piazza Miraglia 2, 80138 Naples, Italy
| | - Michele Torella
- Department of Translational Medical Sciences, Section of Cardiac Surgery and Heart Transplant, University of Campania Luigi Vanvitelli, 81100 Caserta, Italy
| | - Nicola Coppola
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, 81100 Caserta, Italy
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Sanghavi R, Ravikumar N, Sarodaya V, Haq M, Sherif M, Harky A. Outcomes in cardiac implantable electronic device-related infective endocarditis: a systematic review of current literature. Future Cardiol 2022; 18:891-899. [PMID: 36073290 DOI: 10.2217/fca-2021-0155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Aim: Cardiac implantable electronic device infective endocarditis is a serious infection with poor prognosis. Materials & methods: The systematic review of the literature was conducted using searches from the various databases. We included studies published between January 2010 and June 2021. Results: A total of 35 articles met the inclusion criteria. Patients were approximately 70 years old and an average of 71.2% of patients were male. The most common presenting feature was a fever. The modified Duke criteria was used to aid diagnosis. Management entailed extraction of the cardiac implantable electronic device in 80.5% of the studies. The overall mortality rates ranged from 4 to 36%. The most frequently isolated organism was Staphylococcus aureus. Conclusion: Cardiac implantable electronic device infective endocarditis needs timely diagnosis and effective management for promising outcomes.
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Affiliation(s)
- Ria Sanghavi
- Department of Medical Sciences, College of Life Sciences, University Of Leicester, Leicester, UK
| | - Nidhruv Ravikumar
- Department of Medicine, School of Medicine, Queen's University Belfast, Belfast, UK
| | - Varun Sarodaya
- Department of General Surgery, Junior Clinical fellow, Barts Health NHS Trust, London, UK
| | - Mawiyah Haq
- Faculty of Medicine, St George's University of London, London, UK
| | - Mohamed Sherif
- Department of Cardiothoracic Surgery, Northern General Hospital, Sheffield, UK
| | - Amer Harky
- Department of Cardiothoracic Surgery, Liverpool Heart & Chest Hospital, Liverpool, UK
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Zweiker D, Melillo F, D’Angelo G, Radinovic A, Marzi A, Cianfanelli L, Altizio S, Limite LR, Paglino G, Frontera A, Nakajima K, Brugliera L, Malatino L, Della Bella P, Mazzone P. Working on the dirty side-the ipsilateral subclavian access for temporary pacing after lead extraction. J Arrhythm 2022; 38:192-198. [PMID: 35387138 PMCID: PMC8977584 DOI: 10.1002/joa3.12677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 12/23/2021] [Accepted: 01/09/2022] [Indexed: 11/28/2022] Open
Abstract
Background Temporary pacing is necessary in pacemaker-dependent patients after transvenous lead extraction (TLE) for cardiac implantable electronic device infection. In case of unavailability of other accesses, we propose to use the ipsilateral subclavian access (ISA) combined with a standard permanent active fixation lead for the temporary pacemaker and present preliminary data. Methods We consecutively enrolled patients undergoing TLE who received a temporary pacemaker using the ISA between August 2016 and April 2020 at our centre. Results During the observation period, 36 patients undergoing TLE for pocket infection (72.2%), endocarditis (25.0%) or other causes received a temporary pacemaker over the ISA. Their mean age was 77.0 ± 10.7 years, and 13.9% were female. Complete TLE was achieved in 94.4%. There were no major periprocedural complications. Intra-hospital mortality was 11.1%. Pocket revision was performed in 19.4%. During long-term follow-up (23 ± 13 months), 8.3% had a relapse of local pocket infection and 2.8% needed rehospitalization for reintervention. Conclusions Temporary pacing using a standard permanent active fixation lead using the ISA is a convenient alternative to conventional venous accesses. However, risks of implanting a lead into a previously infected area have to be taken into account.
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Affiliation(s)
- David Zweiker
- Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific InstituteVita‐Salute University and San Raffaele HospitalMilanItaly
- Third Clinical Department for Cardiology and Intensive CareKlinik OttakringViennaAustria
- Division of CardiologyMedical University of GrazGrazAustria
| | - Francesco Melillo
- Department of Cardiovascular Imaging Unit, IRCCS San Raffaele Scientific InstituteVita‐Salute University and San Raffaele HospitalMilanItaly
| | - Giuseppe D’Angelo
- Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific InstituteVita‐Salute University and San Raffaele HospitalMilanItaly
| | - Andrea Radinovic
- Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific InstituteVita‐Salute University and San Raffaele HospitalMilanItaly
| | - Alessandra Marzi
- Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific InstituteVita‐Salute University and San Raffaele HospitalMilanItaly
| | - Lorenzo Cianfanelli
- Cardiac Rehabilitation UnitIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Savino Altizio
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific InstituteVita‐Salute University and San Raffaele HospitalMilanItaly
| | - Luca R. Limite
- Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific InstituteVita‐Salute University and San Raffaele HospitalMilanItaly
| | - Gabriele Paglino
- Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific InstituteVita‐Salute University and San Raffaele HospitalMilanItaly
| | - Antonio Frontera
- Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific InstituteVita‐Salute University and San Raffaele HospitalMilanItaly
| | - Kenzaburo Nakajima
- Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific InstituteVita‐Salute University and San Raffaele HospitalMilanItaly
| | - Luigia Brugliera
- Cardiac Rehabilitation UnitIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Lorenzo Malatino
- Department of Clinical and Experimental MedicineUniversity of CataniaCataniaItaly
| | - Paolo Della Bella
- Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific InstituteVita‐Salute University and San Raffaele HospitalMilanItaly
| | - Patrizio Mazzone
- Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific InstituteVita‐Salute University and San Raffaele HospitalMilanItaly
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Maciel ADS, Silva RMFLD. Clinical Profile and Outcome of Patients with Cardiac Implantable Electronic Device-Related Infection. Arq Bras Cardiol 2021; 116:1080-1088. [PMID: 33825793 PMCID: PMC8288527 DOI: 10.36660/abc.20190546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 06/16/2020] [Indexed: 12/11/2022] Open
Abstract
Fundamento Houve aumento expressivo na incidência de infecções relacionadas a dispositivos cardíacos eletrônicos implantáveis (DCEI) nos últimos anos, com impacto na mortalidade. Objetivos Verificar a proporção de pacientes com infecção de DCEI e analisar seu perfil clínico, as variáveis relacionadas com a infecção e sua evolução. Método Estudo retrospectivo, observacional e longitudinal com 123 pacientes com infecção de DCEI entre 6.406 procedimentos. Foram usados os testes paramétricos, e o nível de significância adotado na análise estatística foi de 5%. Resultados A idade média dos pacientes foi de 60,1 anos, e 71 eram homens. A média de internação foi de 35,3 dias, e houve remoção total do sistema em 105 pacientes. Identificaram-se endocardite infecciosa (EI) e sepse em 71 e 23 pacientes, respectivamente. A mortalidade intra-hospitalar foi 19,5%. Houve associação entre EI e extrusão do gerador (17,0% vs. 19,5% nos grupos com e sem EI, respectivamente, p = 0,04; associação inversa) e sepse (15,4% vs. 3,2%, p = 0,01). Houve associação entre morte intra-hospitalar e EI (83,3% vs. 52,0% com e sem morte, respectivamente, p = 0,005) e sepse (62,5% vs. 8,1%, p < 0,0001). Foi dada alta hospitalar a 99 pacientes. Durante a média de seguimento clínico de 43,8 meses, a taxa de mortalidade foi de 43%, e 65,2% dos pacientes com sepse faleceram (p < 0,0001). A curva de sobrevida de Kaplan-Meier não indicou associação significante com sexo, agente etiológico, fração de ejeção, EI e modalidade de tratamento. A taxa de mortalidade foi de 32,8% entre os pacientes submetidos a reimplante de eletrodos por via endocárdica e 52,2% entre aqueles por via epicárdica (p = 0,04). Não houve influência da etiologia chagásica, a qual correspondeu a 44,7% das cardiopatias de base, quanto às variáveis clínicas e laboratoriais ou à evolução. Conclusões A taxa de infecção foi de 1,9%, com predomínio em homens. Houve associação entre mortalidade intra-hospitalar e EI e sepse. Após a alta hospitalar, a taxa de mortalidade anual foi de 11,8%, com influência de sepse durante a internação e o implante epicárdico. (Arq Bras Cardiol. 2021; [online].ahead print, PP.0-0)
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Perrin T, Deharo JC. Therapy and outcomes of cardiac implantable electronic devices infections. Europace 2021; 23:iv20-iv27. [PMID: 34160599 PMCID: PMC8221052 DOI: 10.1093/europace/euab016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 01/13/2021] [Indexed: 11/20/2022] Open
Abstract
Cardiac implantable electronic device (CIED) infection causes significant morbidity and mortality without appropriate treatment. It can present as incisional infection, pocket infection, systemic CIED infection, or occult bacteraemia. Complete percutaneous CIED extraction (excepted in case of incisional infection) and appropriate antibiotic therapy are the two main pillars of therapy. Device reimplantation, if needed, should be delayed sufficiently to allow control of the infection. Here, we address the differences in prognosis according to the clinical scenario and the different treatment options.
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Affiliation(s)
- Tilman Perrin
- Department of Cardiology, Solothurner Spitäler Bürgerspital, Solothurn, Switzerland
- Department of Cardiology, Centre Hospitalier Universitaire La Timone, 264 Rue Saint-Pierre, F-13005 Marseille, France
| | - Jean-Claude Deharo
- Department of Cardiology, Centre Hospitalier Universitaire La Timone, 264 Rue Saint-Pierre, F-13005 Marseille, France
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Dębski M, Ząbek A, Boczar K, Urbańczyk-Zawadzka M, Lelakowski J, Małecka B. Temporary external implantable cardioverter-defibrillator as a bridge to reimplantation after infected device extraction. J Arrhythm 2018; 34:77-80. [PMID: 29721118 PMCID: PMC5828266 DOI: 10.1002/joa3.12026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 11/21/2017] [Indexed: 11/11/2022] Open
Abstract
Patients with cardiac implantable electronic devices (CIED) and endovascular infection represent a difficult management group. The explantation of an implantable cardioverter-defibrillator (ICD) system deprives the patient of the protection against life-threatening ventricular tachyarrhythmias. In this study, we describe feasibility and clinical outcomes of bridging with temporary dual-coil ICD lead and external ICD following the extraction of a CIED due to endovascular infection and compare the performance of this approach to other available options.
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Affiliation(s)
- Maciej Dębski
- Department of Electrocardiology John Paul II Hospital Krakow Poland
| | - Andrzej Ząbek
- Department of Electrocardiology John Paul II Hospital Krakow Poland
| | - Krzysztof Boczar
- Department of Electrocardiology John Paul II Hospital Krakow Poland
| | | | - Jacek Lelakowski
- Department of Electrocardiology John Paul II Hospital Krakow Poland.,Institute of Cardiology Jagiellonian University Medical College Krakow Poland
| | - Barbara Małecka
- Department of Electrocardiology John Paul II Hospital Krakow Poland.,Institute of Cardiology Jagiellonian University Medical College Krakow Poland
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