Benefits
One major benefit of LPs over transvenous systems is the low risk of infection, which is especially important in patients with artificial heart valves. Prosthetic valve endocarditis is the most common form of endocarditis, affecting approximately 4.5% of AVR patients (8). The presence of a cardiac implantable electronic device (CIED) is an independent risk factor (1.6x) for prosthetic valve endocarditis (9). The relationship is likely explained by CIED infection causing bacteremia and seeding of prosthetic valves. Armed with this knowledge, some electrophysiologists are reticent to perform early implantation of a CIED, particularly in post-operative patients who often have indwelling vascular catheters and chest tubes. The current study demonstrates a high rate of late AV recovery, consistent with previously studies that show up to 40% late recovery in AV conduction following valve intervention (10). For those patients with recovery, the ability to program the device “off” obviates the safety issues that can arise in comparison to the unpredictable asynchronous behaviors of a transvenous system at EOL. Thus, LPs could be considered a bridge to AV conduction recovery with a minimal hardware footprint for many of these patients.