Long-term results of conservative treatment of pacemaker pocket site infections

Introduction
The increasing frequency of cardiac device use has led to an increase in complication rates. The standard treatment for cardiac device-related infections is removal of the entire pacemaker system and reimplantation from the contralateral side after systemic antibiotherapy. The efficacy of various conservative treatments has been established for many years, but there is conflicting information in the literature regarding long-term efficacy. Aim: Our study investigated the long-term efficacy of conservative treatment in patients with pacemaker pocket site infection.

Material and methods
In this retrospective study, according to the exclusion criteria, 132 patients were included. Patients were divided into conservative and standard treatment groups. Conservative treatment was considered to be opening the pacemaker pocket capsule, removing all infected and necrotic tissue, cleaning the capsule, and embedding the battery in the prepectoral region in the subpectoral muscle region.

Results
The follow-up time was 36 ±12.96 months in the conservative treatment group and 39.6 ±10.8 months in the standard treatment group. During this period, no re-infection at the pacemaker pocket site was observed in either group. Examination of the swab cultures of the patients’ pacemaker wounds revealed negative culture results in 15 patients (15 out of 60) in the conservative treatment group. In the standard treatment group, 60 patients (60 out of 72) were culture-negative. This difference was statistically significant (p = 0.04).

Conclusions
After a rigorous evaluation, conservative treatment is considered effective and safe in the long term in patients with device pocket site infection.