| Long-term outcomes after pocket or scar revision and reimplantation of pacemakers with preerosion. | |
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MedLine Citation:
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PMID: 21070257 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Introduction: Cardiac pacemakers with preerosion are often reimplanted. Preerosion may be caused by an evolving local infectious process affecting the entire pacing system or by mechanical migration of the device causing ischemic necrosis of the skin tissues. We examined the long-term outcome of 33 patients who underwent pocket or scar revision and submuscular reimplantation of cardiac pacemakers in our institution. Methods: Before undergoing pocket or scar revision and reimplantation, all patients (1) had negative serial blood cultures, (2) had no vegetation on transesophageal echocardiography, (3) had a normal blood C-reactive protein concentrations, (4) were afebrile, (5) had no cutaneous breakthrough, and (6) presented with preerosion of the pulse generator or granulomatous-like scar abnormality. Results: The mean follow-up was 37 ± 12 months. Among 16 patients presenting with preerosion associated with signs of local cutaneous inflammation, 62.5% developed an infection of the pacing system requiring later explantation. Of eight patients presenting initially with migration of the pulse generator and mechanical protrusion, none required subsequent explantation of the system. Among nine patients presenting initially with granulomatous-like scar abnormalities, 55.6% underwent explantation of the pacing system during follow-up for management of documented local infection. Conclusions: The reimplantation of pulse generators with preerosion in the presence of local inflammatory manifestations or granulomatous-like changes of the scar is complicated by documented cardiac pacemaker infection in >50% of cases. In these patients, the explantation of the pacing system is recommended before the development of prognostically much more serious spread of infection to the leads and cardiac tissues. (PACE 2011; 34:150-154). |
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Authors:
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Romain Cassagneau; Sylvain Ploux; Philippe Ritter; Emilie Jan; Laurent Barandon; Antoine Deplagne; Jacques Clementy; Michel Haïssaguerre; Pierre Bordachar |
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Publication Detail:
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Type: Journal Article Date: 2010-11-11 |
Journal Detail:
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Title: Pacing and clinical electrophysiology : PACE Volume: 34 ISSN: 1540-8159 ISO Abbreviation: Pacing Clin Electrophysiol Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-02-08 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7803944 Medline TA: Pacing Clin Electrophysiol Country: United States |
Other Details:
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Languages: eng Pagination: 150-4 Citation Subset: IM |
Copyright Information:
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©2010, The Authors. Journal compilation ©2010 Wiley Periodicals, Inc. |
Affiliation:
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Hopital Cardiologique Haut Leveque, University Bordeaux 2, Bordeaux-Pessac, France. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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