Document Detail


Device-related infection among patients with pacemakers and implantable defibrillators: incidence, risk factors, and consequences.
MedLine Citation:
PMID:  20102431     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Device-related infection is a major limitation of device therapy for cardiac arrhythmia. METHODS: The authors analyzed the incidence and risk factors for cardiac device infection (CDI) among consecutive patients implanted with pacemaker (PM) or implantable cardioverter defibrillator (ICD) (including cardiac resynchronization therapy devices) at a tertiary health center in Hamilton, Ontario, Canada. Most patients with device-related infections were identified by an internal infection control system that reports any positive wound and blood cultures following surgery, between 2005 and the present. A retrospective review of patient records was also performed for all patients who received an ICD or PM between July 1, 2003 and March 20, 2007. RESULTS: A total of 24 infections were identified among 2,417 patients having device surgery (1%). Fifteen of these infections (60%) were diagnosed within 90 days of the last surgical procedure. Univariate analysis showed that patients presenting with CDI were more likely to have had a device replacement, rather than a new implant, had more complex devices (dual/triple chamber vs single), and were more likely to have had a prior lead dislodgement. Multivariate analysis found device replacement (P = 0.02) and cardiac resynchronization therapy (CRT)/dual-chamber devices (P = 0.048) to be independent predictors of infection. One patient developed septic pulmonary emboli after having laser-assisted lead extraction. No patient died and 22 patients received a new device. CONCLUSION: CDI occurs in about 1% of cases in high volume facilities. Pulse generator replacement surgery and dual- or triple-chamber device implantation were associated with a significantly increased risk of infection.
Authors:
Pablo B Nery; Russell Fernandes; Girish M Nair; Glen L Sumner; Carlos S Ribas; Syamkumar M Divakara Menon; Xiaoyin Wang; Andrew D Krahn; Carlos A Morillo; Stuart J Connolly; Jeff S Healey
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-01-22
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  21     ISSN:  1540-8167     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-26     Completed Date:  2010-11-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  786-90     Citation Subset:  IM    
Affiliation:
University of Ottawa Heart Institute, Canada.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Anti-Bacterial Agents / therapeutic use
Chi-Square Distribution
Defibrillators, Implantable / adverse effects*
Device Removal
Female
Humans
Incidence
Male
Middle Aged
Ontario
Pacemaker, Artificial / adverse effects*
Prosthesis Design
Prosthesis-Related Infections / epidemiology,  etiology*,  therapy
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Grant Support
ID/Acronym/Agency:
//Canadian Institutes of Health Research
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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