Background: Infections are among the most frequent and life-threatening complications
of cardiovascular implantable electronic device (CIED) implantation. The aim of this study is to
compare the outcome and safety of a single-procedure device extraction and contralateral implantation
versus the standard-of-care (SoC) two-stage replacement for infected CIEDs. Methods: We
retrospectively included 66 patients with CIED infections who were treated at two Italian hospitals.
Of the 66 patients enrolled in the study, 27 underwent a single procedure, whereas 39 received SoC
treatment. All patients were followed up for 12 months after the procedure. Results: Considering
those lost to follow-up, there were no differences in the mortality rates between the two cohorts,
with survival rates of 81.5% in the single-procedure group and 84.6% in the SoC group (p = 0.075).
Conclusions: Single-procedure reimplantation associated with an active antibiofilm therapy may
be a feasible and effective therapeutic option in CIED-dependent and frail patients. Further studies
are warranted to define the best treatment regimen and strategies to select patients suitable for the
single-procedure reimplantation.