Results
A total of 181 patients underwent WD implantation at Mayo Clinic in
Rochester, MN during the study period. Average age at implant was 75
years (± 7.9). Patients were followed for a total of 534.7 patient years
with an average follow-up time of 2.9 years. The median
CHA2DS2-VASc Score was 4 (interquartile
range 2) and the median HAS-BLED Score was 3 (interquartile range 1).
Gastrointestinal bleeding (n=56, 30.7%), intracerebral hemorrhage
(n=51, 28.0%), and patient preference to avoid anticoagulation (n=23,
12.6%) constituted the most common indications for WD implantation.
There were no instances of WD-related infection or endocarditis
throughout the follow up period. There were 6 patients who had evidence
of bacteremia post implantation. Pathogens identified included viridans
group Streptococcus , Escherichia coli ,Streptococcus agalactiae , Micrococcusluteus , methicillin-susceptible Staphylococcusaureus , and Pseudomonas aeruginosa . Infectious
syndromes included an implantable cardioverter defibrillator associated
endocarditis, sepsis secondary to a urinary source, and sepsis secondary
to a pulmonary source [Table 1] . Five of six BSI episodes
occurred > 3 months post implantation; one occurred 26 days
post implantation. None of the 6 patients who had BSI developed
significant peri-device leak, defined as greater than 5mm in size. No
subsequent TEE showed evidence of device vegetation. A total of 37
patients died during follow-up with an overall mortality of 20.4%,
however no death was infection related.