Patient characteristics
Between July 2013 and May 2022, a total of 102 patients (mean age
67.2±13 years, 32.4% female) underwent CIED extraction with either
total capsulectomy (n=54) or CHG (n=48) scrubbing performed during the
procedure. The mean follow-up was 638 days. The most frequently removed
devices were single or dual-chamber pacemakers (n=44, 43.1%), cardiac
resynchronization therapy and defibrillator devices (n=31, 30.4%);
followed by implantable cardioverter-defibrillators (n=27, 26.5%). The
extraction cause was equally distributed between bacteremia/infective
endocarditis (50%) and device extrusion/pocket infection (50%), with
no statistically significant differences between both groups. No
significant differences in baseline characteristics between groups were
found (Table 1 ). Bacteria were isolated from blood, pocket, or
lead tip cultures in 67.6% of cases. Gram-positive bacteria, including
methicillin-sensitive and methicillin-resistant Staphylococcus aureus
(MSSA and MRSA, respectively), coagulase-negative staphylococcus (CoNS),
and Streptococcus spp. were the most frequently found causative
organisms. Complete procedural success was achieved in 84 patients
(94.4%), and clinical success was achieved in 86 patients (96.6%) with
no significant differences between groups. The length of stay was
similar in the capsulectomy vs. CHG group (18.5±20.2days vs. 23.7±26.4
respectively, p=0.262). Fifty-six patients (54.9%) had a new device
implanted, with no significant differences in the percentage of patients
having a new implant between groups (53.7% vs. 56.3% in the
capsulectomy vs. CHG, p=0.844).
The mean for the reimplant procedure was 125.3±241.6 days in the
capsulectomy group vs. 38.7±78.3 days in the CHG group (p=0.076); in the
capsulectomy group 10 patients (34.5%) and 14 patients (51.9%) in the
CHG had a new device implanted within a week from the extraction (p =
0.28). Regarding the type of placed device, 37.9% of patients in the
capsulectomy group had a pacemaker (either single or dual chamber, or
leadless), compared to 66.7% of patients in the CHG group. In the
remaining patients in each group, the implanted device was related to
underlying heart failure (i.e., an ICD or a CRT device). Procedural
characteristics are shown presented in Table 2 .