TIMING OF THE DELAYED CARDIAC REIMPLANTATION IN CIED INFECTION: A CASE REPORT

Abstract

ICD implantation, such as other surgical procedures, was not free from complications, first of all infection’s development. This complication often induces partial or complete device extraction, followed by a re-implantation. Re-implantation timing is modulated depending on the resolution of the infection and presence or absence of a spontaneous cardiac rhythm. A 62 years old patient was treated with CIED implantation after a diagnosis of atrioventricular cardiac conduction alteration. Healthcare workers diagnosed a pocket infection about a month after implantation and performed a device complete extraction, without programming a re-implantation because of a pro-inflammatory state. He died from acute arrhythmia fourteen days after the device extraction. Recent guidelines deal with therapeutic approaches' disputes, indicating a two weeks waiting before the ICD re-implantation in case of infection, not providing any indication in patients with alteration of pro-inflammatory parameters. Further studies are awaited to deal with disputes of appropriate therapeutic approaches' timing and implement future guidelines.