(FIT)-Module 5 Workshop 9: Arrhythmia Case Studies (Putting It All Together for the Boards)-Ellenbogen Case 5B Question

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Video Summary

A patient with a past dual-chamber ICD placement for sudden cardiac death prevention presents with a swollen, mildly tender ICD pocket nine months post-op. Labs indicate elevated white blood cell count, but normal inflammatory markers and negative blood cultures. Given the presumed infection, treatment options include oral bactrim therapy, surgical intervention with antimicrobial envelope, aspiration and culture, or ICD system extraction with a wearable defibrillator. Discontinuing Apixaban is also considered. The next best treatment involves choosing one of these approaches based on further clinical evaluation and risk assessment.

Keywords

dual-chamber ICD

ICD pocket infection

elevated white blood cell count

oral bactrim therapy

ICD system extraction