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Defibrillator infection

Mariusz Kusztal, Krzysztof Nowak
For arrhythmia treatment or sudden cardiac death prevention in hemodialysis patients, there is a frequent need for placement of a cardiac implantable electronic device (pacemaker, implantable cardioverter defibrillator, or cardiac resynchronization device). Leads from a cardiac implantable electronic device can cause central vein stenosis and carry the risk of tricuspid regurgitation or contribute to infective endocarditis. In patients with end-stage kidney disease requiring vascular access and cardiac implantable electronic device, the best strategy is to create an arteriovenous fistula on the contralateral upper limb for a cardiac implantable electronic device and avoidance of central vein catheter...
March 1, 2018: Journal of Vascular Access
Serge Boveda, Tej Elbanet Chalbia, Sophie Jacob, Stéphane Combes, Nicolas Combes, Christelle Cardin, Guillaume Laborie, Maria Joao Sousa, Zeynab Jebberi, Sophia Mzoughi, Jean-Paul Albenque, Rui Providencia
BACKGROUND: Post-procedural recovery following sub-cutaneous ICD (S-ICD) implantation is feared to be more painful and to require more prolonged hospital admission. The purpose of this study was to compare peri-procedural and short clinical outcomes of the S-ICD vs. the Transvenous ICD (TV-ICD). METHODS: We conducted a single-center cross-sectional study including all consecutive patients who underwent S-ICD implantation by the same operator since January 2016 and a gender and age-matched control group with all single chamber TV-ICD implanted patients over a contemporary time period...
May 1, 2018: International Journal of Cardiology
Sérgio Barra, Rui Providência, Serge Boveda, Rudolf Duehmke, Kumar Narayanan, Anthony W Chow, Olivier Piot, Didier Klug, Pascal Defaye, Daniel Gras, Jean-Claude Deharo, Paul Milliez, Antoine Da Costa, Pierre Mondoly, Jorge Gonzalez-Panizo, Christophe Leclercq, Patrick Heck, Munmohan Virdee, Nicolas Sadoul, Jean-Yves Le Heuzey, Eloi Marijon
OBJECTIVE: In patients indicated for cardiac resynchronisation therapy (CRT), the choice between a CRT-pacemaker (CRT-P) versus defibrillator (CRT-D) remains controversial and indications in this setting have not been well delineated. Apart from inappropriate therapies, which are inherent to the presence of a defibrillator, whether adding defibrillator to CRT in the primary prevention setting impacts risk of other acute and late device-related complications has not been well studied and may bear relevance for device selection...
March 14, 2018: Heart: Official Journal of the British Cardiac Society
Gabriele Dell'Era, Matteo Ziacchi, Eleonora Prenna, Igor Diemberger, Marco Varalda, Cristian Martignani, Federico Guerra, Mauro Biffi, Eraldo Occhetta
BACKGROUND: The management of patients explanted for implantable defibrillator (ICD) infections may be complex when anti-bradycardia pacing and tachyarrhythmia protection are needed. We aimed to test the efficacy and safety of a conventional ICD externally connected to a transvenous dual-coil lead as bridging therapy before the re-implantation. METHODS AND RESULTS: We enrolled seven patients explanted for ICD infections and needing prolonged antibiotic therapy in two high-volume hospitals in Italy and treated them with a passive can external ICD for a mean of 13 (4-30) days before re-implant...
March 8, 2018: Pacing and Clinical Electrophysiology: PACE
Barbara Małecka, Andrzej Ząbek, Maciej Dębski, Krzysztof Boczar, Magdalena Kostkiewicz, Jacek Lelakowski
No abstract text is available yet for this article.
2018: Cardiology Journal
Alexander Kypta, Hermann Blessberger, Juergen Kammler, Alexander Nahler, Kurt Neeser, Michael Lichtenauer, Christoph Edlinger, Joerg Kellermair, Daniel Kiblboeck, Thomas Lambert, Johannes Auer, Clemens Steinwender
INTRODUCTION: Intra-operative complications like mechanical damages to the leads, infections and hematomas during generator replacements of implantable pacemakers and defibrillators contribute to additional costs for hospitals. The aim of this study was to evaluate operation room use, costs and budget impact of generator replacements using either a traditional surgical intervention (TSI) with scissors, scalpel and electrocautery vs. a new radiofrequency energy based surgical system, called PEAK PlasmaBladeTM (PPB)...
2018: PloS One
Nitesh Sood, David T Martin, Rachel Lampert, Jeptha P Curtis, Craig Parzynski, Jude Clancy
BACKGROUND: Transvenous lead extraction is an integral part of management of patients with cardiovascular implantable electronic devices. Real-world incidence and predictors of perioperative complications in extractions involving implantable cardioverter-defibrillator leads have not been described in detail. METHODS AND RESULTS: Data from the National Cardiovascular Data Registry Implantable Cardioverter-Defibrillator Registry were analyzed. Lead extraction was defined as removal of leads implanted for >1 year...
February 2018: Circulation. Arrhythmia and Electrophysiology
Vishesh Kumar, Shahbaz A Malik, Maryam Sheikh, Adam Stys
Infections are known complications of cardiovascular implantable electronic devices (CIEDs). We describe a case of a 62-year-old male who presented with pulseless electrical activity (PEA) cardiac arrest and respiratory failure. He had a history of cardiac resynchronization device and defibrillator (CRT-D) implantation for nonischemic cardiomyopathy. After resuscitation, he was found to have methicillin sensitive Staphylococcus aureus (MSSA) bacteremia on blood culture and large vegetations on the CRT-D lead and tricuspid valve found on echocardiography...
January 2018: South Dakota Medicine: the Journal of the South Dakota State Medical Association
Serge Boveda, Radoslaw Lenarczyk, Stefano Fumagalli, Roland Tilz, Kinga Goscinska-Bis, Maciej Kempa, Pascal Defaye, Christelle Marquié, Alessandro Capucci, Laura Ueberham, Nikolaos Dagres
The purpose of this European Heart Rhythm Association (EHRA) prospective snapshot survey is to provide an overview of the factors influencing patient selection for the implantation of a particular type of device: subcutaneous implantable cardioverter-defibrillator (S-ICD) or transvenous implantable cardioverter-defibrillator (TV-ICD), across a broad range of tertiary European centres. A specially designed electronic questionnaire was sent via the internet to tertiary reference centres routinely implanting both TV-ICDs and S-ICDs...
February 8, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Bruna Bolzan, Martina Morosato, Domenico Caponi, Luca Tomasi, Giuseppe Silvestre, Giovanni Morani
OBJECTIVES: Pacemakers and implantable cardioverter defibrillators have become more common in younger individuals, owing to broader indications and technological advances. Our goal was to report our long-term experience of implanting cardiac devices in young adults via a subaxillary approach with a hidden single incision, to minimize the aesthetic impact of the device. METHODS: From 2003 to 2012, 23 patients underwent cardiac device implantation via a subaxillary approach while they were under general anaesthesia...
February 1, 2018: Interactive Cardiovascular and Thoracic Surgery
Ana C Alba, Farid Foroutan, Nicholas Kwet Vong Ng Fat Hing, Chun-Po S Fan, Cedric Manlhiot, Heather J Ross
PORPUSE: Sudden cardiac death (SCD) is an important post-transplant problem being responsible for approximately 10% of deaths. We conducted a systematic review and meta-analysis to evaluate incidence and predictors of post-heart transplant SCD, and use of implantable cardiac defibrillator (ICD). METHODS: Citations were identified in electronic databases and references of included studies. Observational studies on adults reporting on incidence and predictors of post-transplant SCD and ICD use were selected...
January 19, 2018: Clinical Transplantation
Anar Mammadli, Veysel Kutay Vurgun, Onur Yıldırım, Ali Timuçin Altın, Başar Candemir, Ömer Akyürek
With the increasing number of implanted pacemakers and implantable cardioverter defibrillators, removal is required more frequently. Presently described is the transvenous extraction of a 26-year-old Accufix atrial lead using a mechanical dilator sheath. A 50-year-old male patient was admitted to the clinic with a pacemaker pocket infection. The atrial lead was an Accufix Bipolar J-Atrial active fixation lead, a model that was recalled in 1994, after reports of 2 deaths and 2 nonfatal injuries related to protrusion of the J retention wire...
January 2018: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Simon Claridge, Jonathan Johnson, Gazi Sadnan, Jonathan M Behar, Bradley Porter, Benjamin Sieniewicz, Tom Jackson, Jessica Webb, Justin Gould, Manav Sohal, Shoaib Hamid, Nik Patel, Jaswinder Gill, Christopher A Rinaldi
BACKGROUND: A proportion of patients who undergo an initial lead extraction procedure will require a second, repeat extraction. Data regarding this clinical entity are scarce and neither the predisposing risk factors for, nor outcomes from these procedures have been described previously. We sought to determine the incidence, risk factors and outcomes of repeat lead extraction. METHODS: A database of extraction procedures from 2001-2015 was analyzed. Repeat extraction procedures were identified and the indication for extraction was dichotomized into infection and lead related problems...
January 5, 2018: Pacing and Clinical Electrophysiology: PACE
Giovanni Morani, Giacomo Mugnai, Bruna Bolzan, Martina Morosato, Luca Tomasi, Sara Ferrari, Corrado Vassanelli
BACKGROUND: Infection is a major complication of pacemaker (PM) and implantable cardioverter-defibrillator (ICD) implantation. The present study sought to analyse the incidence rate of device infections, to investigate possible relationships between first implantations/repeated procedures and infection rates, and to identify some main risk factors associated with infection of cardiac implantable electronic devices (CIED). METHODS: In a single center retrospective observational study, records of 3899 consecutive patients having undergone PM and ICD implantation, cardiac resynchronization therapy (CRT) or revision (device/lead replacements or upgrades) and between 2002 and 2012 were obtained...
January 5, 2018: Minerva Cardioangiologica
Alexander Khodak, Adam S Budzikowski
BACKGROUND: Barbed suture use in surgical fields such as gynecology and orthopedic surgery has been associated with faster wound closure, improved cosmesis, increased cost-effectiveness and potentially decreased rates of infection. However, the use of barbed suture in electrophysiology device procedures has not been reported. OBJECTIVE: This study aims to (1) investigate the safety and effectiveness of barbed suture in wound closure in patients after EP implantable cardioverter defibrillators and loop recorders (CIED) procedures, (2) to determine whether these sutures have an advantage in device implant procedures by improving incision integrity, (3) and to find out whether these sutures would potentially lead to lower rates of infections compared to non-barbed sutures...
April 2017: Journal of Atrial Fibrillation
A Schlitt, M Guha, M Noutsias, H H Klein, H U Klein
Assessment of a permanent risk of life-threatening ventricular arrhythmia in patients with severely reduced left ventricular ejection fraction (LVEF <35%), e. g. after myocarditis, dilated cardiomyopathy, acute myocardial infarction, in patients with postpartum cardiomyopathy or implantable cardioverter-defibrillator (ICD) and cardiac resynchronization treatment plus defibrillator (CRT-D) infection with temporary explantation of the system is a medical challenge. This is time-consuming and unsafe because life-threatening ventricular arrhythmias may occur during the time of risk assessment...
December 12, 2017: Herz
John J Lee, Daniel Weitz, Rishi Anand
BACKGROUND: Recent studies have shown that insertable cardiac monitors (ICMs) can be implanted out of the traditional hospital setting and efforts are being made to explore the feasibility of implanting these devices in a specific standardized location other than the operating room or a cardiac catherization/electrophysiology lab. METHODS: This was a prospective, non-randomized, single center post-market clinical trial designed to occur in the holding area of a hospital operating room or cardiac catheterization/electrophysiology laboratory...
November 2017: Indian Pacing and Electrophysiology Journal
L Castro, S Pecha, M Linder, J Vogler, N Gosau, C Meyer, S Willems, H Reichenspurner, S Hakmi
BACKGROUND: The approach to treat device infection in patients with implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy defibrillator (CRT-D) is a challenging procedure. Optimal treatment is complete extraction of the infected device. To protect these patients from sudden cardiac arrest while waiting for reimplantation and to avoid recurrent infection, a wearable cardioverter defibrillator (WCD) seems to be a valuable solution. Therefore, we investigated the management and outcome of patients with ICD or CRT-D infections using the WCD as a bridge to re-implantation after lead extraction procedures...
November 25, 2017: Journal of Cardiothoracic Surgery
Elif Kaya, Matthias Totzeck, Tienush Rassaf
BACKGROUND: The pulsed electron avalanche knife (PEAK) PlasmaBlade™ is an innovative electrosurgical device that uses a novel technology to cut tissues. It has been proven to be safe and feasible in ear, nose, and throat surgery, but there are only limited data concerning the use of PlasmaBlade™ instead of conventional electrocautery in cardiac implantable electronic device (CIED) procedures except for generator replacements. METHODS: We conducted a retrospective, single-center study with patients undergoing CIED surgery at our center between December 2015 and March 2017 and evaluate the feasibility and the clinical outcome of the PlasmaBlade™...
November 21, 2017: European Journal of Medical Research
Muhammad R Afzal, Divyesh Mehta, Christopher Evenson, Daniel Pinkhas, Auroa Badin, Dilesh Patel, Michael K Essandoh, Hemant Godara, Jaret Tyler, Mahmoud Houmsse, Zhenguo Liu, Steven J Kalbfleisch, John D Hummel, Ralph Augostini, Raul Weiss, Emile G Daoud, Toshimasa Okabe
BACKGROUND: The perioperative anticoagulation management during subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation is still evolving. OBJECTIVE: The purpose of this study was to assess whether it is safe to perform S-ICD implantation with uninterrupted warfarin. METHODS: This is a single-center retrospective review of patients undergoing S-ICD implantation between October 1, 2012 and June 30, 2017. One hundred thirty-seven patients underwent successful S-ICD implantation during the study period...
November 13, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
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