Implantable cardiac electronic device infections: single center study
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Implantable cardiac electronic device (ICED) infections include- lead infection (ICED-LI), device pocket infection (PI) and infective endocarditis (ICED-IE). The aim of this study is to analyze the records of patients with ICED, who developed implantable device-related infections. We analyzed retrospectively the records of the University Clinical Centre (Gdańsk) patients who in 2012-2018 underwent transvenous lead extraction (TLE) due to infections. In order to identify potential ICED infection risk factors we included patients who underwent any electrotherapy procedure within 2 years prior to the TLE. ICED infections that led to septic shock were defined as severe. The analyzed sample included 59 patients with infectious complications (37 male and 22 female) with median age of 74. The in-hospital mortality was 8.5%. All patients with severe ICED infection were diagnosed with ICED-LI, whereas the rest of the sample was diagnosed mostly with PI (p<0.001). The most commonly cultured pathogens were S. aureus and S. epidermidis. In the analyzed sample, the most common infectious complication related to the ICED was PI and the most common etiological agents were S. aureus and S. epidermidis. Severe ICED infections that present with septic shock are associated with a 50% in-hospital mortality rate.
- Sandoe JAT, Barlow G, Chambers JB, Gammage M, Guleri A, Howard P, et al. Guidelines for the diagnosis, prevention and management of implantable cardiac electronic device infection. Report of a joint Working Party project on behalf of the British Society for Antimicrobial Chemotherapy (BSAC, host organization), British Heart Rhythm Society (BHRS), British Cardiovascular Society (BCS), British Heart Valve Society (BHVS) and British Society for Echocardiography (BSE). J Antimicrob Chemother. 2015;70(2):325–359.
- Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The third international consensus definitions for sepsis and septic shock (sepsis-3). Jama. 2016;315(8):801–810.
- Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373–383.
- Tarakji KG, Ellis CR, Defaye P, Kennergren C. Cardiac implantable electronic device infection in patients at risk. Arrhythmia Electrophysiol Rev. 2016;5(1):65.
- Baddour LM, Epstein AE, Erickson CC, Knight BP, Levison ME, Lockhart PB, et al. Update on cardiovascular implantable electronic device infections and their management: a scientific statement from the American Heart Association. Circulation. 2010;121(3):458–477.
- Ann HW, Ahn JY, Jeon YD, Jung IY, Jeong SJ, Joung B, et al. Incidence of and risk factors for infectious complications in patients with cardiac device implantation. Int J Infect Dis. 2015;36:9–14.
- Sohail MR, Uslan DZ, Khan AH, Friedman PA, Hayes DL, Wilson WR, et al. Management and outcome of permanent pacemaker and implantable cardioverter-defibrillator infections. J Am Coll Cardiol. 2007;49(18):1851–1859.
- Deharo J-C, Quatre A, Mancini J, Khairy P, Le Dolley Y, Casalta J-P, et al. Long-term outcomes following infection of cardiac implantable electronic devices: a prospective matched cohort study. Heart. 2012;98(9):724–731.
- Uslan DZ, Sohail MR, Sauver JLS, Friedman PA, Hayes DL, Stoner SM, et al. Permanent pacemaker and implantable cardioverter defibrillator infection: a population-based study. Arch Intern Med. 2007;167(7):669–675.
- Voigt A, Shalaby A, Saba S. Rising rates of cardiac rhythm management device infections in the United States: 1996 through 2003. J Am Coll Cardiol. 2006;48(3):590–591.
- Nakajima H, Taki M. Incidence of cardiac implantable electronic device infections and migrations in Japan: results from a 129 institute survey. J arrhythmia. 2016;32(4):303–307.
- Lekkerkerker JC, van Nieuwkoop C, Trines SA, van der Bom JG, Bernards A, van de Velde ET, et al. Risk factors and time delay associated with cardiac device infections: Leiden device registry. Heart. 2009 May 1;95(9):715–720.
- Małecka B, Ząbek A, Ciaś A, Stępiński J, Kutarski A, Rońda J, et al. Endocardial silicone lead wear: description of tribological phenomena on the basis of microscopic examination of removed leads. Preliminary report. Kardiol Pol (Polish Hear Journal). 2014;72(10):960–968.
- Polyzos KA, Konstantelias AA, Falagas ME. Risk factors for cardiac implantable electronic device infection: a systematic review and meta-analysis. Europace. 2015;17(5):767–777.
- Sławiński G, Kempa M, Lewicka E, Budrejko S, Królak T, Raczak G. Elevated Creactive protein levels during cardiac implantations may increase the risk of early complications requiring transvenous lead removal: a preliminary report. Polish Arch Intern Med. 2018;128(2):138–140.
- Sohail MR, Hussain S, Le KY, Dib C, Lohse CM, Friedman PA, et al. Risk factors associated with early-versus late-onset implantable cardioverter-defibrillator infections. J Interv Card Electrophysiol. 2011;31(2):171–183.
- Ahmed I, Gertner E, Nelson WB, House CM, Dahiya R, Anderson CP, et al. Continuing warfarin therapy is superior to interrupting warfarin with or without bridging anticoagulation therapy in patients undergoing pacemaker and defibrillator implantation. Hear Rhythm. 2010;7(6):745–749.
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