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https://www.readbyqxmd.com/read/29672690/infections-and-associated-costs-following-cardiovascular-implantable-electronic-device-implantations-a-nationwide-cohort-study
#1
Nicolas Clémenty, Phuong Lien Carion, Lucie de Léotoing, Ludovic Lamarsalle, Fanny Wilquin-Bequet, Benedict Brown, Koen J P Verhees, Jérôme Fernandes, Jean-Claude Deharo
Aims: This study assessed the contemporary occurrence of cardiac device infections (CDIs) following implantation in French hospitals and estimated associated costs. Methods and Results: A retrospective analysis was conducted on the French National Hospital Database (PMSI). Patients with a record of de novo cardiac implantable electronic device (CIED) implantation or replacement interventions in France in 2012 were identified and followed until the end of 2015. Cardiac device infections (CDIs) were identified based on coding using the French classification for procedures [Classification Commune des Actes Médicaux (CCAM)] and International Classification of Diseases (ICD-10)...
April 17, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29607624/burden-and-consequences-of-retained-cardiovascular-implantable-electronic-device-lead-fragments-after-heart-transplantation
#2
Paulino A Alvarez, Brett W Sperry, Antonio L Perez, Kenneth Varian, Timothy Raymond, Michael Tong, Ayman A Hussein, David O Taylor
We performed a retrospective review of 402 consecutive patients who underwent heart transplantation at our institution between January 2009 and March 2017. A retained cardiovascular implantable electronic device (CIED) fragment was identified after transplantation in 49 of the 301 patients (16.2%) with CIED at baseline. Patients with retained fragments had leads with longer dwell times (median 2596 [1982, 3389] vs 1384 [610, 2202] days, p<0.001), higher prevalence of previously abandoned leads (14.3% vs 2...
April 1, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29584858/incidence-and-factors-associated-with-infective-endocarditis-in-patients-undergoing-left-sided-heart-valve-replacement
#3
Lauge Østergaard, Nana Valeur, Nikolaj Ihlemann, Morten Holdgaard Smerup, Henning Bundgaard, Gunnar Gislason, Christian Torp-Pedersen, Niels Eske Bruun, Lars Køber, Emil Loldrup Fosbøl
Aims: Patients with left-sided heart valve replacement are considered at high-risk of infective endocarditis (IE). However, data on the incidence and risk factors associated with IE are sparse. Methods and results: Through Danish administrative registries, we identified patients who underwent left-sided heart valve replacement from January 1996 to December 2015. Patients were categorized in mitral and aortic valve replacement (MVR and AVR) and followed until: 12 years after valve surgery, end of study, death, emigration, or hospitalization due to IE, whichever came first...
March 23, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29564522/antibiotic-prophylaxis-practices-in-pediatric-cardiac-implantable-electronic-device-procedures-a-survey-of-the-pediatric-and-congenital-electrophysiology-society-paces
#4
Spenser Y Chen, Scott R Ceresnak, Kara S Motonaga, Anthony Trela, Debra Hanisch, Anne M Dubin
Cardiac implantable electronic device (CIED) infections are associated with significant morbidity in the pediatric device population, with a tenfold higher risk of infection in children compared to adults. The 2010 American Heart Association (AHA) guidelines recommend a single dose of systemic antibiotic (ABX) prophylaxis prior to CIED implantation and no post-operative (OP) ABX. However, there is limited data regarding adherence to this recommendation among the pediatric community. To assess current clinical practices for CIED ABX prophylaxis in pediatrics; whether the AHA guidelines are being followed; and if not, the reasons for non-adherence...
March 22, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29563819/a-case-of-brucella-melitensis-endocarditis-in-a-patient-with-cardiovascular-implantable-electronic-device
#5
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
https://www.readbyqxmd.com/read/29518265/attempted-salvage-of-infected-cardiovascular-implantable-electronic-devices-are-there-clinical-factors-that-predict-success
#6
James E Peacock, Jeanette M Stafford, Katherine Le, Muhammad Rizwan Sohail, Larry M Baddour, Jordan M Prutkin, Stephan B Danik, Holenarasipur R Vikram, Marta Hernandez-Meneses, José M Miró, Elisabeth Blank, Christoph K Naber, Roger G Carrillo, Arnold J Greenspon, Chi-Hong Tseng, Daniel Z Uslan
BACKGROUND: Published guidelines mandate complete device removal in cases of cardiovascular implantable electronic device (CIED) infection. Clinical predictors of successful salvage of infected CIEDs have not been defined. METHODS: Data from the Multicenter Electrophysiologic Device Infection Collaboration (MEDIC), a prospective, observational, multinational cohort study of CIED infection, were utilized to investigate whether clinical predictors of successful salvage of infected devices could be identified...
March 8, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29508843/application-of-an-infection-control-protocol-icp-reduced-cardiac-device-infection-cdi-in-low-volume-centers
#7
Gongchang Guan, Zhongwei Liu, Yong Zhang, Fangyun Wang, Haiming Ji, Xuewen Li, Yuan Chen, Xiaoqiang Yang, Jianxia Wei, Kai Yu, Ming Zhang
BACKGROUND Cardiac device infection (CDI) is a serious complication of cardiovascular implantable electronic device (CIED) implantations. Many risk factors have been identified, but several are still uncertain. This study aimed to identify and evaluate the risk factors. Moreover, an infection control protocol (ICP) was carried out, and its efficacy in reducing CDIs was investigated. MATERIAL AND METHODS A total of 1259 patients who received permanent pacemaker (PPM) implantations were enrolled in this study in a 3-year period in a high-volume center and low-volume centers in the central area of Shaanxi Province, China...
March 6, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29428137/management-of-device-infections
#8
REVIEW
Khalid Aljabri, Ann Garlitski, Jonathan Weinstock, Christopher Madias
The rate of cardiac implantable electronic device (CIED) infection has increased disproportionately to the rate of implantation. Expanded indications for CIED implantation combined with a sicker patient population contribute to this increased rate. Device-related infections are most commonly due to perioperative contamination, and infection risk increases in conjunction with procedural complexity. Early pocket re-exploration and upgrade procedures confer a higher infectious risk. Confirmed CIED infection requires prompt removal of the CIED system combined with antimicrobial therapy...
March 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29428134/lead-management-and-lead-extraction
#9
REVIEW
Charles J Love
Management of patients with cardiac implantable electronic devices (CIEDs) has become complex given the complications that can occur with implanted lead systems. Clinical problems such as infection, lead failure, and occluded vessels create situations that demand intervention to remove leads. Due to adhesions that occur in the venous system and at the endomyocardial attachment site, simple traction to remove a lead is often not sufficient. Infection is a mandatory reason to remove the entire CIED system. Tools and techniques are now available that enable a skilled operator to extract leads with a great deal of efficacy and safety...
March 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29419605/ceftaroline-for-suspected-or-confirmed-invasive-methicillin-resistant-staphylococcus-aureus-a-pharmacokinetic-case-series
#10
Jeffrey J Cies, Wayne S Moore, Adela Enache, Arun Chopra
OBJECTIVES: To describe the ceftaroline pharmacokinetics in critically ill children treated for suspected or confirmed methicillin-resistant Staphylococcus aureus infections, including blood stream infection and describe the microbiological and clinical outcomes. DESIGN: Retrospective electronic medical record review. SETTINGS: Free-standing tertiary/quaternary pediatric children's hospital. PATIENTS: Critically ill children receiving ceftaroline monotherapy or combination therapy for suspected or confirmed methicillin-resistant S...
February 6, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29411401/treatment-patterns-costs-and-mortality-among-medicare-beneficiaries-with-cied-infection
#11
Arnold J Greenspon, Elizabeth L Eby, Allison A Petrilla, M Rizwan Sohail
BACKGROUND: Cardiac implantable electronic device (CIED) infection is a serious adverse event, but there are limited contemporary real-world data on treatment pathways and associated costs in the Medicare population following diagnosis of CIED infection. Hence, this study evaluates post-infection treatment pathways and associated healthcare expenditures and mortality among Medicare fee-for service (FFS) beneficiaries with CIED infection. METHODS: Retrospective cohort analysis of 5,401 beneficiaries who developed a device-related infection in the year following implantation/upgraded CIED (1/1/2010-12/31/2012)...
February 6, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29378721/risk-factors-and-outcomes-of-endocarditis-due-to-non-hacek-gram-negative-bacilli-data-from-the-prospective-multicenter-sei-cohort
#12
Marco Falcone, Giusy Tiseo, Emanuele Durante-Mangoni, Veronica Ravasio, Francesco Barbaro, Maria Paola Ursi, Maria Bruna Pasticci, Matteo Bassetti, Paolo Grossi, Mario Venditti, Marco Rizzi
Objective: To investigate predisposing factors and outcomes of non-HACEK Gram-negative bacilli (GNB) infective endocarditis (IE) in a multicenter, contemporary cohort. Patients and Methods: Patients with IE due to GNB prospectively observed in 26 Italian centers from 2004 to 2011 were analyzed. Using a case-control design, each case was compared to three controls with IE by other etiologies matched for age and sex. Logistic regression was performed to identify risk factors for GNB IE. Factors associated with early and late mortality were assessed by Cox regression analysis...
January 29, 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29364546/use-of-antibiotic-envelopes-to-prevent-cardiac-implantable-electronic-device-infections-a-meta-analysis
#13
Scott M Koerber, Mohit K Turagam, Jeffery Winterfield, Sandeep Gautam, Michael R Gold
INTRODUCTION: The rates of cardiac implantable electronic device (CIED) infections have risen over the past decade and are associated with increased hospitalizations and mortality. A number of preventative strategies have been developed including an antibiotic coated envelope, but it has yet to gain widespread use. METHODS: A meta-analysis was performed on controlled studies of the antibiotic envelope. PubMed and Google Scholar were searched for studies comparing infection rates with and without the use of an antibiotic envelope...
April 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29341172/statin-use-and-the-risk-of-cardiovascular-implantable-electronic-device-infection-a-cohort-study-in-a-veteran-population
#14
Talal Alzahrani, Angelike P Liappis, Larry M Baddour, Pamela E Karasik
BACKGROUND: The rate of cardiovascular implantable electronic device infection (CIEDI) has increased, despite the use of perioperative antibiotics at the time of device placement or revision. This is due, in part, to the presence of multiple comorbid conditions in an elderly population, in general, who require CIED. Statins may have an antibacterial effect, although there is currently no evidence that the likelihood of CIEDI has been impacted by statin use. METHODS: A retrospective cohort study was performed to assess whether statins are associated with a reduced risk of CIEDI...
January 17, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29290748/therapeutic-drug-monitoring-of-prolonged-infusion-aztreonam-for-multi-drug-resistant-pseudomonas-aeruginosa-a-case-report
#15
Jeffrey J Cies, Richard J LaCoursiere, Wayne S Moore, Arun Chopra
Aztreonam, a broad-spectrum monobactam, is typically reserved for multidrug resistant (MDR) infections. Pharmacokinetic (PK) data to guide dosing in children, however, are limited to healthy volunteers or nonintensive care unit (ICU) patients. Impaired antibiotic delivery into tissue remains a major concern and may explain the high morbidity and mortality associated with MDR infections. Therefore, evaluating the PK changes in pediatric ICU patients is necessary to elucidate the most appropriate antimicrobial regimen...
November 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29250294/use-of-barbed-suture-for-wound-closure-in-electrophysiology-device-procedures
#16
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
https://www.readbyqxmd.com/read/29250274/prevention-of-cardiac-implantable-electronic-device-infections-update-and-evaluation-of-the-potential-role-for-capsulectomy-or-the-antibiotic-pouch
#17
REVIEW
Marye J Gleva, Jeanne E Poole
Cardiac implantable electronic device (CIED) infections can have devastating implications for patient morbidity and mortality. Over the past decade, the infection rate has risen out of proportion to implant rates, and has prompted the development of innovative solutions designed to reduce infections. The first section of this review provides a summary of the contemporary knowledge regarding the incidence, prevalence, microbiology, and risk factors for cardiac implantable electronic device infections. The second section addresses prevention with an emphasis on the potential role of novel procedural approaches, such as capsulectomy and the antibacterial envelope, in reducing CIED infection...
February 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29188432/-18-f-fdg-pet-ct-now-endorsed-by-guidelines-across-all-types-of-cied-infection-evidence-limited-but-growing
#18
EDITORIAL
Fozia Zahir Ahmed, Parthiban Arumugam
No abstract text is available yet for this article.
November 29, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29171319/cost-effectiveness-of-tyrx-absorbable-antibacterial-envelope-for-prevention-of-cardiovascular-implantable-electronic-device-infection
#19
Gemma Kay, Elizabeth L Eby, Benedict Brown, Julie Lyon, Simon Eggington, Gayathri Kumar, Elisabeth Fenwick, M Rizwan Sohail, David Jay Wright
AIMS: Infection is a major complication of cardiovascular implantable electronic device (CIED) therapy that usually requires device extraction and is associated with increased morbidity and mortality. The TYRX Antibacterial Envelope is a polypropylene mesh that stabilizes the CIED and elutes minocycline and rifampin to reduce the risk of post-operative infection. METHODS: A decision tree was developed to assess the cost-effectiveness of TYRX vs standard of care (SOC) following implantation of four CIED device types...
March 2018: Journal of Medical Economics
https://www.readbyqxmd.com/read/29162159/pulsed-electron-avalanche-knife-peak-plasmablade%C3%A2-in-pacemaker-and-defibrillator-procedures
#20
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
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