PO-04-091 UTILITY OF AN EXTERNALIZED TEMPORARY TRANSVENOUS ICD SYSTEM IN THE SETTING OF VT STORM AND CONCURRENT ICD DEVICE INFECTION REQUIRING EXTRACTION

With the expanding use of CIED therapy, intravascular device infections are becoming more common. In case transvenous ICD requiring extraction for bacterial clearance, there remains no standard method to deliver temporary therapy following removal. We present a bacteremia and VT storm where CRT-D system is performed facilitate clearance. Given active ventricular arrhythmias, externalized with dual-coil lead used treat episodes prior reimplantation new permanent device. N/A A 78-year-old man presented dyspnea, hypotension, storm. His past medical history includes nonischemic cardiomyopathy, chronic HFrEF, recurrent monomorphic status post LV summit ablation in April, 2022, initial implant right-sided single chamber 2007 followed by upgrade 2016 improvement LVEF from 15% 40%. He was found have enterococcus faecalis bacteremia. Despite ongoing amiodarone he had 5 6-hour period. Four (CL 380-420msec) were successfully treated round ATP one episode 300msec) terminated an shock. TEE without evidence endocarditis. appropriate antibiotic blood cultures remained positive suggesting infection. Laser-assisted Concurrently, RV DF1 placed via right axillary vein programming set bipolar sensing / delivery shock vector involving only SVC coils. All vectors incorporating can deactivated. The patient multiple successful therapies utilizing (Figure) need external defibrillation. reimplant 7 days after extraction. discharged plans complete six week course antibiotics. Management arrhythmias resistant pharmacologic be challenging setting This demonstrates utility detection pace-termination VT, thereby avoiding defibrillator therapy.