Cardiac implantable electronic device infections: Who is at greatest risk?

Joy, Parijat S.; Kumar, Gagan; Poole, Jeanne E.; London, Barry; Olshansky, Brian

doi:10.1016/j.hrthm.2017.03.019

Cited by 78 publications

(87 citation statements)

References 20 publications

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“…Elderly patients usually have lower organ function, more comorbidity, and poorer nutrition, 13 each of which increases the risk of postoperative infection. The rate of infection of cardiac implantable electric devices has been reported at 2.06% of overall age on average 14 . In our study, such infection developed in two patients (5.7%) within 6 months after TV implantation (one pocket infection and one infective endocarditis), but no such infection was observed in the LP group (Table 3).…”

Section: Discussionmentioning

confidence: 46%

The feasibility of leadless pacemaker implantation for superelderly patients

Tachibana

Banba

Matsumoto

et al. 2020

Pacing Clinical Electrophis

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Background:The safety and efficacy of the leadless pacemaker (LP) have been confirmed in previous reports, yet studies on LPs in superelderly patients are limited. Methods and Results:A total of 62 patients aged over 85 years old were implanted with singlechamber pacemakers due to symptomatic bradyarrhythmia at Sakakibara Heart Institute from May 2014 through July 2019. We divided them into two groups, a transvenous (TV) singlechamber pacemaker group (35 patients) and an LP group (27 patients), and compared the groups.Mean participant age was 90.3 ± 3.8 y.o., 41.9% were male, and mean participant body mass index (BMI) was 21.3 kg/m 2 . The LP group contained a significantly larger proportion of patients with dementia than the TV group did (63% vs. 37.1%, P = .04). The complication-free rate tended to be lower in the LP group in spite of the higher frequency of dementia (88.6% vs. 92.6%, P = .68). At implantation, the pacing threshold was significantly higher in the LP group than in the TV group (1.30 ± 0.91 V vs. 0.71 ± 0.23 V, P < .01), but over the first 3 months after the operation the pacing threshold in the LP group gradually improved (0.82 ± 0.2 V vs. 1.05 ± 1.02 V, P = .16). The procedure time and time from operation to discharge were also shorter in the LP group. Conclusions: LP implantation appears to be safe and is accordingly becoming the cornerstone for Japanese superelderly patients indicated for single-chamber pacemakers, even for those with small bodies and dementia. However, careful procedures and long follow-ups are needed until a greater volume of data is reported. K E Y W O R D S leadless pacemaker, Micra Transcatheter Pacing System, single-chamber pacemaker 1 The reported risk factors of cardiac injury related to the LP operation are as follows; age ≥ 85, body mass index (BMI) <20 kg/m 2 , 374 c ○ 2020 Wiley Periodicals, Inc.Pacing Clin Electrophysiol. 2020;43:374-381. wileyonlinelibrary.com/journal/pace

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Section: Discussionmentioning

confidence: 46%

The feasibility of leadless pacemaker implantation for superelderly patients

Tachibana

Banba

Matsumoto

et al. 2020

Pacing Clinical Electrophis

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“…These data raise questions. By analogy, if attention is given to the spinal cord stimulator and cardiac electronic implants, recent studies did not show an increased rate of infection for men. In our study, we could assume that factors associated with the male gender, such as hair growth, hormonal factors, or fat distribution, are implicated.…”

Section: Discussionmentioning

confidence: 99%

Is Sacral Nerve Modulation a Good Option for Fecal Incontinence in Men?

Brochard

Mège

Bridoux

et al. 2019

Neuromodulation: Technology at the Neural Interface

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“…Some lead-related complications are potentially lethal, i.e. heart perforation, cardiac device-related infective endocarditis, or haemothorax [3,11,12]. Totally subcutaneous ICDs were developed to overcome the problems connected with the leads implanted to the heart [6,7].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, in selected patients, insertion of an intracardiac lead may be difficult or impossible (i.e. in the case of subclavian vein occlusion) [3][4][5].…”

Section: Introductionmentioning

confidence: 99%