Preventive infection control in cardiac device implantation
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Original Contributions Herzschr Elektrophys https://doi.org/10.1007/s00399-020-00727-2 Received: 13 August 2020 Accepted: 28 September 2020
Maha Mohamed Mohamed Khalifa · Michel Lotfy Kolta · Mazen Tawfik · Said Khaled · Emad Effat Fakhry
© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2020
Preventive infection control in cardiac device implantation
Department of cardiology, Ain Shams University Hospital, Cairo, Egypt
Electronic supplementary material
on the patient and healthcare services [3, 4].
The online version of this article (https://doi. org/10.1007/s00399-020-00727-2) contains supplementary material, which is available to authorized users.
Aim of the study
Background Cardiac implantable electronic devices (CIED) have been increasingly used in recent years. These include single-chamber (VVI) and dual-chamber pacemakers (DDD), which have been used for the management of significant brady arrhythmias, as well as implantable cardiac devices (ICD)and cardiac resynchronization therapy (CRT) with or without defibrillator, which have been used in patients with severely impaired systolic function, with or without life threatening arrhythmias [1]. There has been a rise in CIED-related complications in recent years with the increase in the number of devices implanted. Major complications of device implantation include: lead dislodgement, cardiac perforation, oversensing and undersensing, increased pacing thresholds, pneumothorax, pocket hematoma, pocket revisions due to pain, devicerelated systemic infection and infective endocarditis [2]. A population-based cohort study in around 5918 patients that underwent CIED implantation revealed that 9.5% of the study population experienced at least one of the abovementioned complications [2]. Device-related infection (DRI), which can be fatal, may affect patient survival, in addition to the high burden it places
The aim of the present study was to analyze the possible factors that could be related to the occurrence of DRI. It also aimed to evaluate adherence to infection control measures in device implantation in the catheter laboratory and study the short-term effectiveness of applying these measures to reduce cardiac device implantation-related infection.
Methods All patients with an indication for cardiac device insertion were enrolled in the study and a 6 month follow-up at the Ain Shams University Hospital in Cairo if they met the criteria set out below.
Inclusion criteria All patients that were indicated for either new-device implantation or battery replacement were enrolled in the study, including the following: 4 Patients with sick sinus syndrome, as well as patients with complete or second-degree heart block with an indication for a VVI or DDD pacemaker. 4 Patients with heart failure who met the guideline criteria for CRT insertion. 4 Patients planned for ICD insertion who met either primary or secondary prevention guideline criteria.
Exclusion criteria Patients were excluded in the case of one or more of the following: 4 Uncorrected cyanotic heart
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