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pacemaker infection guidelines

Elif Kaya, Reza Wakili, Tienush Rassaf
The subcutaneous implantable cardioverter-defibrillator (S-ICD®, Boston Scientific, Marlborough, MA, USA, previously Cameron Health, San Clemente, CA, USA) represents an important milestone in ICD therapy for prevention of sudden cardiac death (SCD). Since the introduction of the S‑ICD in 2010, the device has undergone further development. Based on the unique feature of an entirely extracardiac implantation, the S‑ICD is able to reduce the common perioperative and long-term complications of the usual endovascular implanted ICD systems...
May 14, 2018: Herzschrittmachertherapie & Elektrophysiologie
Wasl Al-Adsani, Ali Ahmad, Mohammad Al-Mousa
Background: Brucellosis is a bacterial infection, caused by the nonmotile gram-negative aerobic coccobacilli. The clinical manifestation of brucellosis is variable, ranging from mild disease to severe disease. The gold standard test to confirm the diagnosis of brucellosis is assaying blood, bone marrow, or other body fluids or by tissue culture. Preferred first-line treatment in adults with uncomplicated, nonlocalized disease consists of doxycycline-aminoglycoside combination. The recommended duration of treatment is 6 weeks...
2018: Infection and Drug Resistance
Alexander James Keeley, Daniel Hammersley, Madhava Dissanayake
We present a successful conservative management strategy for a frail elderly patient with a cardiac resynchronisation pacemaker who presented with evidence of an Enterobacter cloacae pacemaker pocket infection. A device washout and debridement procedure was performed, with reburial of the device in a new prepectoral pocket and creation of a closed-loop continuous antibiotic infusion into the infected pacemaker pocket. This was followed by a 6-week course of ambulatory intravenous antibiotic therapy. This conservative management strategy avoided the need for a more invasive and high-risk full device extraction, which the patient clearly stated he did not wish to have...
June 20, 2017: BMJ Case Reports
Jason W Greenberg, Timothy S Lancaster, Richard B Schuessler, Spencer J Melby
Postoperative atrial fibrillation (POAF) is a common, expensive and potentially morbid complication following cardiac surgery. POAF occurs in around 35% of cardiac surgery cases and has a peak incidence on postoperative day 2. Patients who develop POAF incur on average $10 000-$20 000 in additional hospital treatment costs, 12-24 h of prolonged ICU time, and an additional 2 to 5 days in the hospital. POAF has been identified as an independent predictor of numerous adverse outcomes, including a 2- to 4-fold increased risk of stroke, reoperation for bleeding, infection, renal or respiratory failure, cardiac arrest, cerebral complications, need for permanent pacemaker placement, and a 2-fold increase in all-cause 30-day and 6-month mortality...
October 1, 2017: European Journal of Cardio-thoracic Surgery
Sana M Al-Khatib, Paul Friedman, Kenneth A Ellenbogen
Advances in the field of defibrillation have brought to practice different types of devices that include the transvenous implantable cardioverter-defibrillator (ICD) with or without cardiac resynchronization therapy, the subcutaneous ICD (S-ICD), and the wearable cardioverter-defibrillator. To ensure optimal use of these devices and to achieve best patient outcomes, clinicians need to understand how these devices work, learn the characteristics of patients who qualify them for one type of device versus another, and recognize the remaining gaps in knowledge surrounding these devices...
November 1, 2016: Circulation
Uğur Kocabaş, Hamza Duygu, Nihan Kahya Eren, Zehra İlke Akyıldız, Serhan Özyıldırım, Selcen Yakar Tülüce, Tuncay Kırış, Cem Nazlı
OBJECTIVE: In recent years there has been an increase in clinical situations requiring lead extraction procedures of implanted cardiac devices. In our clinic, extraction procedures are performed with Evolution® mechanical lead extraction system. In this manuscript we aimed to evaluate our lead extraction procedures. METHODS: We retrospectively evaluated lead extraction procedures carried out on 41 patients [30 male, 11 female patient; mean age 61.5 ± 18.5 median 67 (23-85)] between 2008 and 2015 using Evolution® system...
2016: SpringerPlus
Andrew S Mackie, Wei Liu, Anamaria Savu, Ariane J Marelli, Padma Kaul
BACKGROUND: In 2007, the American Heart Association (AHA) published revised guidelines for infective endocarditis (IE) prophylaxis. Population-based data with respect to the potential impact of these revised guidelines are lacking. METHODS: The Canadian Institute for Health Information Discharge Abstract Database was used to identify all hospitalizations between April 2002 and March 2013 having IE as a primary diagnosis. Hospitalization rates were determined using age-specific population data from Statistics Canada...
August 2016: Canadian Journal of Cardiology
Justin Glavis-Bloom, Scott Vasher, Meghan Marmor, Antonella B Fine, Philip A Chan, Karen T Tashima, John R Lonks, Erna M Kojic
Use of cardiovascular implantable electronic devices (CIED), including permanent pacemakers (PPM) and implantable cardioverter defibrillators (ICD), has increased dramatically over the past two decades. Most CIED infections are caused by staphylococci. Fungal causes are rare and their prognosis is poor. To our knowledge, there has not been a previously reported case of multifocal Candida endocarditis involving both a native left-sided heart valve and a CIED lead. Here, we report the case of a 70-year-old patient who presented with nausea, vomiting, and generalised fatigue, and was found to have Candida glabrata endocarditis involving both a native aortic valve and right atrial ICD lead...
November 2015: Mycoses
Uğur Kocabaş, Hamza Duygu, Nihan Kahya Eren, Zehra İlke Akyıldız, Serhan Özyıldırım, Selcen Yakar Tülüce, Cem Nazlı
OBJECTIVE: In recent years, there has been an increase in clinical situations requiring extraction of leads of implanted cardiac devices. This study aimed to evaluate the Evolution Mechanical Dilator Sheath system, presently in use in our clinic for lead extraction procedures. METHODS: Lead extraction procedures carried out on 20 patients (14 men, 6 women; mean age 61±19; range 23 to 85 years) between 2008 and 2013 using the Evolution system were retrospectively evaluated...
June 2015: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Daniel Brancheau, George Degheim, Christian Machado
A 53-year-old gentleman with a history of a mechanical aortic valve presented to the emergency department complaining of a sudden right-sided abdominal pain. He was found to have atrioventricular dissociation on his initial electrocardiogram and his blood cultures grew Streptococcus viridans. The suspicion for endocarditis with periaortic abscess was high so a transthoracic echocardiogram was performed and showed a mass in the left ventricular outflow tract. For better visualization, a transesophageal echocardiogram was recommended and revealed a bileaflet mechanical aortic valve with perivalvular abscess and valvular vegetation as well as severe eccentric paravalvular aortic regurgitation...
2015: Case Reports in Cardiology
Jonathan A T Sandoe, Gavin Barlow, John B Chambers, Michael Gammage, Achyut Guleri, Philip Howard, Ewan Olson, John D Perry, Bernard D Prendergast, Michael J Spry, Richard P Steeds, Muzahir H Tayebjee, Richard Watkin
Infections related to implantable cardiac electronic devices (ICEDs), including pacemakers, implantable cardiac defibrillators and cardiac resynchronization therapy devices, are increasing in incidence in the USA and are likely to increase in the UK, because more devices are being implanted. These devices have both intravascular and extravascular components and infection can involve the generator, device leads and native cardiac structures or various combinations. ICED infections can be life-threatening, particularly when associated with endocardial infection, and all-cause mortality of up to 35% has been reported...
February 2015: Journal of Antimicrobial Chemotherapy
Domenico Santoro, Filippo Benedetto, Placido Mondello, Narayana Pipitò, David Barillà, Francesco Spinelli, Carlo Alberto Ricciardi, Valeria Cernaro, Michele Buemi
A well-functioning vascular access (VA) is a mainstay to perform an efficient hemodialysis (HD) procedure. There are three main types of access: native arteriovenous fistula (AVF), arteriovenous graft, and central venous catheter (CVC). AVF, described by Brescia and Cimino, remains the first choice for chronic HD. It is the best access for longevity and has the lowest association with morbidity and mortality, and for this reason AVF use is strongly recommended by guidelines from different countries. Once autogenous options have been exhausted, prosthetic fistulae become the second option of maintenance HD access alternatives...
2014: International Journal of Nephrology and Renovascular Disease
Michał Chudzik, Andrzej Kutarski, Przemysław Mitkowski, Andrzej Przybylski, Joanna Lewek, Barbara Małecka, Tomasz Smukowski, Aleksander Maciąg, Janusz Smigielski
INTRODUCTION: Over the last 10 years, there has been an increasing number of patients with pacemaker (PM) and cardioverter-defibrillator (ICD). This study is a retrospective analysis of indications for endocardial pacemaker and ICD lead extractions between 2003 and 2009 based on the experience of three Polish Referral Lead Extraction Centers. MATERIAL AND METHODS: Since 2003, the authors have consecutively retrospectively collected all cases and entered the information in the database...
May 12, 2014: Archives of Medical Science: AMS
Michael Koutentakis, Stavros Siminelakis, Panagiotis Korantzopoulos, Anastasios Petrou, Alexandra Petrou, Helen Priavali, Eleftheria Priavali, Andreas Mpakas, Helen Gesouli, Eleftheria Gesouli, Efstratios Apostolakis, Eleftheria Apostolakis, Kosmas Tsakiridis, Paul Zarogoulidis, Nikolaos Katsikogiannis, Ioanna Kougioumtzi, Nikolaos Machairiotis, Theodora Tsiouda, Konstantinos Zarogoulidis
PURPOSE: The infection of cardiac implantable electronic devices (CIED) is a serious and potentially lethal complication. The population at risk is growing, as the device implantation is increasing especially in older patients with associated comorbid conditions. Our purpose was to present the management of this complicated surgical condition and to extract the relevant conclusions. METHODS: During a 3-year period 1,508 CIED were implanted in our hospital. We treated six cases of permanent pacemaker infection with localized pocket infection or endocarditis...
March 2014: Journal of Thoracic Disease
Valerio Zacà, Rossella Marcucci, Guido Parodi, Ugo Limbruno, Pasquale Notarstefano, Paolo Pieragnoli, Andrea Di Cori, Maria Grazia Bongiorni, Giancarlo Casolo
In Italy tens of thousands of patients undergo implantation or replacement of cardiac implantable electronic devices (CIEDs) annually, and up to 50% of these subjects receive antiplatelet agents or oral anticoagulants. The rate of CIED-related complications, mainly infective, has also significantly increased, so that transvenous lead extraction procedures are often required. CIED surgery is peculiar and portends specific intrinsic risks of developing life-threatening hemorrhagic complications; on the other hand periprocedural discontinuation of antithrombotic therapy in patients at high thromboembolic risk may have catastrophic consequences...
January 2014: Giornale Italiano di Cardiologia
Amar R Mohee, Robert West, Wazir Baig, Ian Eardley, Jonathan A T Sandoe
OBJECTIVE: To evaluate the association between urological procedures and the development of infective endocarditis (IE), as there are case-reports linking urological procedures to IE but evidence of a causal relationship is lacking and no major guidelines advise prophylaxis to prevent development of IE during transurethral urological procedures. No case-control study has been undertaken to examine the relationship between urological procedures and the development of IE. PATIENTS AND METHODS: Retrospective evaluation of the IE database at our institution...
July 2014: BJU International
Tina S Tischer, Anne Hollstein, Wolfgang Voss, Imke Wendig, Jörg Lauschke, Ralph Schneider, Georg H von Knorre, Dietmar Bänsch
AIMS: The approach to infected cardiac devices has changed during recent decades. Optimal treatment is still a matter of debate, especially in pacemaker-dependent patients. Therefore, we investigated the management and outcome of patients with pacemaker infections in a single centre over four decades. METHODS AND RESULTS: We conducted a retrospective analysis of 4212 patients and extracted those with pacemaker infections admitted to Rostock Heart Center between 1973 and 2012...
February 2014: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
J Alberto Lopez
AIMS: Current guidelines recommend that patients with infected cardiac rhythm management device (CRMD) sites undergo removal of all system components (pulse-generator and leads). However, lead removal may not be an option for patients who lack access to state-of-the-art technology, lack the necessary financial resources, or are at very high risk because of age or concomitant disease. In this case series, we report our successful experience with conservative treatment of five such patients, who had CRMD infections localized to the device pocket...
April 2013: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Arif Asif, Roger Carrillo, Juan Domingo Garisto, Mauricio Monrroy, Rao Ali Hashim Khan, Hector Castro, Donna Merrill, Ayesha S Ali, Amy Barton Pai, Jonathan Waldman, Loay Salman
Cardiac implantable electronic device (CIED) leads can cause central venous stenosis (CVS). In addition, these devices can get infected. Both are critically important considerations in patients with chronic kidney disease (CKD) for at least two reasons: (i) central veins serve as the final pathway should these patients need an arteriovenous access to provide dialysis therapy; and (ii) the presence of renal failure increases the risk of CIED infection. In this analysis, we investigated the prevalence as well as the degree of chronic kidney disease in patients harboring a CIED...
January 2013: Seminars in Dialysis
Ali Oto, Kudret Aytemir, Uğur Canpolat, Hikmet Yorgun, Levent Şahiner, Ergün Bariş Kaya, Giray Kabakçi, Lale Tokgözoğlu
BACKGROUND: With developing technology, transvenous lead extraction (TLE) has undergone an explosive evolution due to incremental problems related to lead infection and malfunction. OBJECTIVE: We aimed to present our experience in TLE with the Evolution®Mechanical Dilator Sheath (Cook Medical, Grandegrift, PA, USA). METHODS: Between June 2009 and July 2011, the Evolution®mechanical dilator sheath was used for the extraction of 140 pacemaker (PM) and implantable cardioverter-defibrillator (ICD) leads in 66 patients...
July 2012: Pacing and Clinical Electrophysiology: PACE
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