Isolated extravascular implantable cardioverter-defibrillator infection without leadless pacemaker involvement: A unique dual-device case report

Implantable cardioverter-defibrillators (ICDs) have been central in the prevention of sudden cardiac death (SCD) for over three decades (1–3). Despite their proven efficacy, traditional transvenous ICD (TV-ICD) systems carry substantial procedural and long-term risks, primarily due to the presence of intravascular leads (4,5). These complications mainly include lead malfunction, venous thrombosis, valvular injury and infection. Although relatively infrequent (0.6-1.3%), TV-ICD infections often require complete system removal and are associated with significant morbidity and mortality (6,7).