Objective:

To compare the infection rates of patients with rechargeable cell (RC) implantable pulse generators (IPGs) to those with primary cell (PC) IPGs.

Background:

RC IPGs extend battery longevity compared to PC IPGs in deep brain stimulation (DBS) procedures. With each subsequent battery replacement procedure, there is a heightened susceptibility to post-operative infections. We conducted this study to evaluate the infection rates between patients with RC IPGs and patients with PC IPGs.

Design/Methods:

We completed a retrospective chart review of all patients who underwent DBS procedures for any indication from 2016 to 2022 at our institution. We included all phases of DBS surgery, including electrode implantation, IPG implantation, IPG replacement, and hardware revisions and removals.

Results:

637 patients underwent 1,521 DBS procedures during the study period. The overall infection rate was 2.56% (n=39/1521) per procedure and 5.02% (n=32/637) per patient. For PC IPGs, the infection rate was 2.69% (n=23/855) per procedure and 4.68% (n=21/449) per PC patient. Infections occurred after PC replacement at the rate of 2.03% (n=13/639). For RC IPGs, the infection rate was 4.55% (n=9/198) per procedure and 3.70% (n=6/162) per RC patient. There were no infections following the 4 RC replacements. There was no difference in infection rates between RC and PC IPGs per procedure (p=0.17) or per patient (p=0.59) after initial IPG implantation. However, one-third of infections (n=13/39) occurred after replacement of PC IPGs, while there were no infections after replacement of RC IPGs during the six-year study duration.

Conclusions:

In this single-center study, patients with RC IPGs had a reduced infection rate compared to patients with PC IPGs from IPG replacement. This difference is likely due to a less frequent need for IPG replacement with RC IPGs.