A propensity-matched cohort study examining the impact of gentamycin-collagen sponge on the prevention of infections in patients with implantable cardioverter defibrillator undergoing revision surgery

Abstract Introduction Despite the obvious benefits, the use of implantable cardioverter defibrillators (ICDs) is associated with serious complications, including infections. In particular, device replacement or revision procedures are associated with an increased risk of infection. Aim of the study was to compare the cardiac device infection rate with and without the use of the gentamycin-collagen sponge (GCS) in patients undergoing device replacement or revision procedures of implanted ICDs. Methods This cohort study analyzed ICD patients from a prospective single-centre ICD-registry who underwent elective device replacement, system upgrade or lead revision between 2014 and 6/2023. From September 2020 onwards, a GCS was inserted into the device pocket (GCS group, n = 204). Each patient of the GCS group was matched to a control without GCS. Results The baseline characteristics and the PADIT score were well matched except for the rate of submuscular device pockets which was lower in the GCS group (Table 1). The GCS was well tolerated and there were no complications associated with the GCS. The Kaplan-Meier estimated infection rate after one year was 1.0% in the GCS group and 6.5% in the control group (p < 0.001, Figure 1). Time from revision to infection was 144 + 134 days in the GCS group vs. 334 + 261 days in the control group. Conclusion Adjunctive use of a GCS was associated with a lower incidence of device infections than standard-of-care infection-prevention strategies alone.Table 1Figure 1