P186 LEADLESS PACEMAKER VERSUS TRANSVENOUS PACEMAKER: THE BEST ALTERNATIVE FOR THE POST–EXTRACTION PATIENT

Abstract Introduction As complications associated with pacemakers or defibrillators implant increase, the number of patients undergoing transvenous lead extraction following infection has increased. This study aims to compare follow–up and to evaluate the incidence of reinfection between post–extracted patients re–implanted with leadless pacemakers and post–extracted patients re–implanted with transvenous device. Materials and Methods From December 2016 to October 2022, 163 patients underwent transvenous lead extraction in our center. Of these patients, 24 were subsequently reimplanted with a leadless pacemaker, while 52 with a traditional device. Instead, 11 were reimplanted with S–ICD, 3 with a loop recorder; 73 are patients who, after cardiological re–evaluation, either didn’t reimplant a new device or were redirected to the first implant center. For each patient has been evaluated the efficacy of the reimplanted device, the appearance of any minor or major complications, the recurrence of infection. Results About the 24 post–extracted patients who were reimplanted with a leadless pacemaker, in no case there was a recurrence of infection and/or complications associated with the device. In the 52 post–extracted patients reimplanted with a traditional device, only 1 case experienced a recurrence of infection (0.02% rate). If we analyze this last class better, we see how in the past some of these had already undergone a pocket overhaul or an extraction of first implant device. Many are also patients with leads abandoned by another center and with new device’s infection. Conclusions Leadless PM implantation in post–extracted patients, when we have patients eligible for this device, proved to be an effective choice in reducing re–infection recurrences compared to the population of patients reimplanted with a transvenous device. However, if we consider the low rate of reinfection in patients re–implanted with transvenous device, we can say that when the patient is well prepared and the implant prophylaxis is correct, the recurrence of infection is low even if one decides to re–implant a traditional device.