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.