Management of cardiac implantable electronic device infection using a complete interdisciplinary approach

Technological advances and increasing operator experience have improved the success rate of transvenous lead extraction (TLE). However, in some cases—especially with longer lead dwelling time—TLE can be highly complicated. In this case report, the authors present an unusual case of implantable cardioverter defibrillator (ICD) pocket infection diagnosed by 18 F‑fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F‑FDG-PET/CT). Complete lead extraction required a combined transvenous and surgical approach. Contralateral reimplantation failed due to occlusion of the right brachiocephalic vein. Therefore, a subcutaneous ICD was implanted. This case highlights the importance of an interdisciplinary approach to the treatment of cardiac implantable electronic device infection.