Table 10.
Recommendations for preventive strategies after device implantation and for new re-implantations including alternative novel devices
| Consensus statement | Statement class | Scientific evidence coding | References |
|---|---|---|---|
| After device extraction, re-assessment of the indication for re-implantation is recommended |
|
O | 38 , 122 |
| Whenever possible, re-implantation may be avoided or delayed until symptoms and signs of systemic and local infection have resolved |
|
O | 38 , 123 |
| A temporary pacemaker with ipsilateral active fixation strategy may be considered in pacemaker-dependent patients requiring appropriate antibiotic treatment before re-implantation |
|
O | 124–127 |
| Preferred access sites for replacement device are the contralateral side, the femoral vein, or epicardially |
|
E, O | 38 , 128 , 129 |
| Temporary pacing in patients who are not pacemaker dependent |
|
O | 28 |
| Replacement device implantation ipsilateral to the extraction site |
|
E | 38 |
| Alternative novel devices as LPM and S-ICD may be considered in selected patients with high infective risk or in patients in whom these devices are considered better options after an CIED infection |
|
O | 129–133 |
CIED, cardiac implantable electronic device; E, expert opinion; LPM, leadless pacemaker; M, meta-analysis; O, observational studies; R, randomized trials; S-ICD, subcutaneous implantable cardiac defibrillator.