Gentamycin Collagen Sponge Inclusion in Pacemaker Generator Change helps Decreasing Pocket Infection Rate to Zero: A Follow-up Analysis of 425 Patients

Objectives: Generator exchange of cardiac implantable electric devices (CIED) is associated with a higher pocket infection than at the primary implantation. Absorbable antimicrobial pouches were introduced for CIED patients; however, it bears a high cost and therefore is not well suitable for routine generator exchanges. This study is to evaluate a simple alternative for prevention of pocket infection after generator exchange.

Methods: In this cross-sectional follow-up study, all elective patients from January 2015 to August 2020, who underwent a CIED generator exchange (including pacemakers, resynchronization devices, and ICDs) were included into the study. They received a Gentamycin collagen sponge which was positioned in the generator pocket. Patients with active pocket infection were excluded from the study. The patients' data were prospectively collected and analyzed. The study end point was the occurrence of generator pocket infection during the follow-up period.

Result: The Study included 425 patients. The mean age was 76 ± 13 years. A total of 48% of patients received a pacemaker, 24% patients received an ICD, and 27% patients received a CRT, 4 patients received a subcutaneous ICD. The median follow-up time was 29 months with interquartile range of 13 to 48 months. The early postoperative freedom from pocket infection was 100%. There were no pocket infections over the entire follow-up period.

Conclusion: Adding a gentamycin collagen sponge into the pocket during CIED generator exchange highly helps avoiding pacemaker pocket infections. It is an easy adjunct to the standard procedure and should be considered whenever possible.

Publication History

Article published online:
19 February 2021