Results of endoscopic electrode removal surgery in patients with cardiovascular implantable electronic devices

Abstract

Introduction: The increasing popularity of permanent pacemakers and implantable cardioverter defibrillators (ICDs) has improved the quality of life and long-term prognosis of cardiovascular patients. However, there is also an increase in infections of cardiac implantable devices (CIEDs). The infection rate after the first implant is 4.82/1000 people, and after the device replacement is 12.12/1000. With the development of endoscopic techniques, a method of thoroughly treating infections of cardiac implantable devices is opened without increasing the severity of the patient’s condition.

Method: Cross-sectional study, 08 patients with pacemaker infection underwent endoscopic surgery at the Cardiovascular Center, E Hospital from January 2020 to July 2024.

Result: In 08 patients, the male ratio is mainly 06 patients, the oldest age was 85 years old and the youngest is 25 years old. There are 07 cases with permanent pacemaker implantation, 1 case of ICD placement Brugada syndrome. All cases have bacterial cultures: 05 patients have Staphylococcus aureus and 03 cases have cultured Staphylococcus epidermidis. All patients have pacemaker examination and underwent endoscopic surgery to remove the electrode. The average surgical time is 68,71± 18.3 minutes (97-40), in which 01 case has only electrode probe infection, the remaining cases has both the pacemaker and electrode probe infection. Most stable cases are discharged from hospital with an average time of 16,2± 7,8 days (11-30), 01 severe case due to sepsis in a patient with heart failure EF: 30%, kidney failure, diabetes, hypertension has to stay in treatment for additional 30 days.

Conclusion: Endoscopic electrode removal surgery in patients with pacemaker infection initially achieved good results, with low complications and mortality, but a larger number of patients and long-term follow-up and evaluation are needed.