| Device-related infection among patients with pacemakers and implantable defibrillators: incidence, risk factors, and consequences. | |
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MedLine Citation:
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PMID: 20102431 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-01-22 |
Journal Detail:
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Title: Journal of cardiovascular electrophysiology Volume: 21 ISSN: 1540-8167 ISO Abbreviation: J. Cardiovasc. Electrophysiol. Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-07-26 Completed Date: 2010-11-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9010756 Medline TA: J Cardiovasc Electrophysiol Country: United States |
Other Details:
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Languages: eng Pagination: 786-90 Citation Subset: IM |
Affiliation:
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University of Ottawa Heart Institute, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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//Canadian Institutes of Health Research |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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