A historical perspective of pacemaker infections: 40-years single-centre experience

Tischer, T.; Hollstein, Anne; Voss, W; Wendig, Imke; Lauschke, Jörg; Schneider, R.; Knorre, G. H. von; Bänsch, Dietmar

doi:10.1093/europace/eut193

Cited by 13 publications

(13 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Interestingly, in the Netherlands, due to lower numbers of intravenous drug users, the frequency of right-sided endocarditis has notably dropped [9]. At the same time, the worldwide rise in methicillin-resistant Staphylococcus aureus (MRSA) has augmented MRSA-related IE [10–14]. Furthermore, there has been a substantial increase in the use of prosthetic heart valves, both mechanical and biological [15].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prognostic factors in infective endocarditis in general hospitals in the Netherlands

et al. 2016

View full text Add to dashboard Cite

IntroductionDespite advances in treatment, infective endocarditis (IE) still ranks amongst the most lethal infectious diseases. We sought to determine prognostic factors in general hospitals in the Netherlands as research in this setting is scarce.ResultsBetween 2004 and 2011, we identified 216 cases of IE, 30.1 % of which were prosthetic valve IE. This leads to an annual incidence of IE of 5.7 new cases per 100,000 persons per year. Women were less likely to undergo surgical intervention (OR = 1.96, 95 % CI 1.06–3.61, p = 0.031). Also, ageing was an independent prognostic factor for not receiving surgery in a multivariate analysis (annual OR = 1.04, 95 % CI 1.02–1.06, p < 0.001). Female sex was a prognostic factor for mortality (OR = 2.35, 95 % CI 1.29–4.28, p = 0.005). Age was also an independent prognostic factor for mortality (OR = 1.05, 95% CI 1.03–1.08, p < 0.001). Conservative treatment was a prognostic factor for mortality (OR = 3.39, 95 % CI 1.80–6.38, p < 0.001) whereas surgical intervention was an independent prognostic factor for adverse events (OR = 3.03, 95% CI 1.64–5.55, p < 0.001). Staphylococcus aureus was an independent prognostic factor for adverse events (OR = 2.05, 95 % CI 1.10–3.84, p = 0.024) but not for mortality.ConclusionThis study shows that endocarditis in general hospitals has a high rate of morbidity and mortality. Even when treated, it ranks as one of the most lethal infectious diseases in the Netherlands, especially in women and the elderly.

show abstract

Section: Introductionmentioning

confidence: 99%

“…Furthermore, there has been a substantial increase in the use of prosthetic heart valves, both mechanical and biological [15]. Also, the increased use of devices such as pacemakers and implantable cardiac defibrillators is posing new challenges [10]. …”

Section: Introductionmentioning

confidence: 99%

Prognostic factors in infective endocarditis in general hospitals in the Netherlands

et al. 2016

View full text Add to dashboard Cite

show abstract

“…For this reason, the guidelines of the AHA/ACC/HRS recommend the removal of all system components (generator and catheters) . Although extraction is the elective treatment in cases of infections of CIEDs, this procedure involves various risks, some of which are serious or even fatal . Although with the advent of laser extraction systems the procedures have been simplified and a success rate of 98% is reported, these data reflect however the situation of very experienced centers with high volumes of procedures .…”

Section: Discussionmentioning

confidence: 99%

“…A closed system of antibiotic irrigation was then applied to the patients during the 72 h after the procedure, and oral antibiotics were prescribed after discharge. Patients were all followed for at least 1 year without evidence of recurrence despite three patients died due to causes not related to device infection . Another example is a recent case report from Schaller et al, which involved a young patient.…”

Section: Discussionmentioning

confidence: 99%

Pacemaker pocket infection: Innovative conservative treatment in elderly patients with no signs of systemic infection

Bisignani

Bonis

Mancuso

et al. 2019

Pacing Clinical Electrophis

View full text Add to dashboard Cite

Background The gold standard to treat cardiovascular implantable electronic devices (CIEDs) infections is the complete system removal. The aim of this retrospective analysis is to assess the feasibility and safety of an alternative conservative surgical system revision approach, to be applied in elderly patients who refused the extraction procedure, in case of no signs of systemic infection. Methods Between May 2009 and January 2019, we performed system revision of 25 patients (15 men and 10 women, median age 81 [IQ: 75‐85] years) with negative blood culture, no signs of vegetation, who experienced CIED infections. Results In all patients the following surgical procedure was applied: the pocket was opened, the wound's necrotic tissue was dissected en bloc; fibrotic tissue was excised. The pocket was washed with hydrogen peroxide and saline solution. The pocket was then closed without implanting the device and left with a continuous infusion of antibiotics and normal saline for 4 days. Subsequently the new generator was implanted, possibly in a different pocket than the previous one. All patients underwent a median follow up of 24 [IQ: 14‐34] months. In 24 patients out of the 25 observed the procedure was safe and effective, except for one patient who needed the extraction. Conclusions The two‐stage surgical revision technique is feasible and safe. It may be considered for elderly patients who refused extraction and presented no signs of systemic infection or in some categories of patients. In case of failure of the procedure, subsequent treatment with complete extraction of the system would not be precluded.

show abstract

“…Some of the common reasons for noncapture include lead dislodgement or break in circuit, lead failure, and inflammation and fibrosis at the electrode‐myocardium interface leading to a higher threshold for stimulation [1]. The usual treatment of a pocket infection involves removing the entire infected pacing system (pulse generator and leads); this reduces the risk of reinfection by 75% [2].…”

Section: Introductionmentioning

confidence: 99%

Failure of communication and capture: The perils of temporary unipolar pacing system

Sahinoglu

Wool

2014

Journal of Arrhythmia

View full text Add to dashboard Cite

We present a case of a patient with pacemaker dependence secondary to complete heart block who developed loss of capture of her temporary pacemaker. Patient developed torsades de pointes then ventricular fibrillation, requiring CPR and external cardioversion. After patient was stabilized, it was noticed that loss of capture of pacemaker corresponded with nursing care, when the pulse generator was lifted off patient׳s chest wall, and that patient׳s temporary pacing system had been programmed to unipolar mode without knowledge of attending cardiologist. This case highlights the importance of communication ensuring all caregivers are aware of mode of the temporary pacing system.

show abstract

A historical perspective of pacemaker infections: 40-years single-centre experience

Cited by 13 publications

References 25 publications

Prognostic factors in infective endocarditis in general hospitals in the Netherlands

Prognostic factors in infective endocarditis in general hospitals in the Netherlands

Pacemaker pocket infection: Innovative conservative treatment in elderly patients with no signs of systemic infection

Failure of communication and capture: The perils of temporary unipolar pacing system

Contact Info

Product

Resources

About