Case-Control Study of Surgical Site Infections Associated With Pacemakers and Implantable Cardioverter-Defibrillators

Marschall, Jonas; Hopkins-Broyles, Diane; Jones, Marilyn C.; Fraser, Victoria J.; Warren, David K.

doi:10.1086/520744

Cited by 12 publications

(7 citation statements)

References 27 publications

(26 reference statements)

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“…8,10,11,16 A recent randomized trial found a higher rate of infection after first implantations compared with after PM replacements. 17 In this trial, however, follow-up was carried out for only 6 months, and the number of infected patients reached 13 in the two treatment arms.…”

Section: Discussionmentioning

confidence: 99%

Infection after pacemaker implantation: infection rates and risk factors associated with infection in a population-based cohort study of 46299 consecutive patients

Johansen

Jørgensen

Møller

et al. 2011

European Heart Journal

338

202

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AimsInfection is a serious complication of pacemaker (PM) systems. Although the rate of infection has been debated, the figures are largely unknown. We therefore studied the incidence of PM infection and its associated risk factors in the Danish population.Methods and resultsSince 1982, all PM implantation and removal procedures performed in Denmark have been prospectively recorded in the Danish Pacemaker Register. All patients (n = 46299) who underwent implantation between 1982 and 2007 were included. The total length of surveillance was 236 888 PM-years. The incidence of infection was calculated according to the total number of PM-years. The incidence of surgical site infection (≤365 days after PM implantation) was compared with later infection in first implant and replacement procedures. Multiple-record and multiple-event-per-subject proportional hazards analyses were used to identify the independent risk factors of PM infection. Surgical site infection occurred in 192 cases after first implantation (incidence rate 4.82/1000 PM-years), and in 133 cases after replacement (12.12/1000 PM-years). Infections occurring more than 365 days after the first implantation occurred in 153 cases (1.02/1000 PM-years), and in 118 cases after replacement (3.26/1000 PM-years). Independent factors associated with an increased risk of PM infection were a greater number of PM operations (including replacements), male sex, younger age, implantation during the earliest part of the study period, and absence of antibiotics (P< 0.001).ConclusionThe overall risk of infection after PM implantation was low. A greater number of operations augmented the risk of infection. This should be taken into account when considering revisions of PM systems.

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Section: Discussionmentioning

confidence: 99%

Infection after pacemaker implantation: infection rates and risk factors associated with infection in a population-based cohort study of 46299 consecutive patients

Johansen

Jørgensen

Møller

et al. 2011

European Heart Journal

338

202

View full text Add to dashboard Cite

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“…Sterile fistulation in the region of the impulse generator was found in 1 dog after 16 months and another dog had an inflammatory reaction around the pulse generator after 4 weeks. Sterile exudation has been described in human medicine but not in dogs 32,33 . Possible explanations include infection of the surgical site or an immune‐mediated reaction to the impulse generator.…”

Section: Discussionmentioning

confidence: 99%

“…Possible explanations include infection of the surgical site or an immune‐mediated reaction to the impulse generator. In human medicine, antibiotic therapy is initiated or the entire pacemaker system is removed 32,33 …”

Section: Discussionmentioning

confidence: 99%

Dual Chamber Pacemaker Implantation in Dogs with Atrioventricular Block

Hildebrandt

Stertmann

Wehner

et al. 2009

Veterinary Internal Medicne

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Background: Pacemaker implantation is the treatment of choice for symptomatic bradyarrhythmias. In dogs, a single chamber system is commonly used. In human patients with high-grade 2nd-or 3rd-degree atrioventricular (AV) block, physiologic pacing is recommended, because it improves cardiac output, blood pressure, exercise tolerance, and quality of life. In dogs, this type of pacing is seldom used.Hypothesis: The implantation of a dual chamber pacemaker in dogs with AV block is a feasible procedure for restoring AV synchrony.Animals: Thirty-three privately owned dogs with high-grade 2nd-or 3rd-degree AV block were included. Methods: Patient data of all dogs with AV block presented for pacemaker implantation between December 1997 and November 2004 were reviewed.Results: Dual chamber pacemaker implantation with AV synchronous stimulation was successfully performed in 33/33 dogs (100%). In 9/33 (27%) major and in 12/33 (36%) minor complications were observed. Mean survival time for the patients discharged from hospital (n 5 32) was 33.6 AE 20.4 months (range, 3.9-83.5 months).Conclusion and Clinical Importance: Dual chamber pacing is a feasible procedure in dogs with 2nd-or 3rd-degree AV block and is not associated with a higher complication rate compared with single chamber pacemaker systems. A major advantage over ventricular demand pacemaker systems is the restoration of AV synchrony for a substantial period of time.

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“…Unfortunately, medical comorbidities and procedure complexity (including multiple device revisions) increase the risk of cardiac device infection [32,34,96]. These factors are generally increasing in prevalence and are nonmodifiable.…”

Section: Expert Commentary and Five-year Viewmentioning

confidence: 99%

Infections of electrophysiologic cardiac devices

Uslan¹

2008

Expert Review of Medical Devices

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Infections related to electrophysiologic cardiac device placement are increasing dramatically and are associated with adverse outcomes. With the US population aging and living longer, cardiac devices are utilized in an older population with significant comorbidities, making the threat from infectious complications significant. Electrophysiologic cardiac devices typically include an implanted pulse generator and an intravascular lead. Infection may occur at any component of the device, resulting in varied presentations. Bacteremia in cardiac device recipients may reflect primary generator pocket infection, or alternate sources of bacteremia may result in secondary hematogenous lead infection. This review focuses on the pathology, diagnosis, management and prevention of electrophysiologic cardiac device infections.

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Case-Control Study of Surgical Site Infections Associated With Pacemakers and Implantable Cardioverter-Defibrillators

Abstract: "Case-control study of surgical site infections associated with pacemakers and implantable cardioverter-defibrillators

Cited by 12 publications

References 27 publications

Infection after pacemaker implantation: infection rates and risk factors associated with infection in a population-based cohort study of 46299 consecutive patients

Infection after pacemaker implantation: infection rates and risk factors associated with infection in a population-based cohort study of 46299 consecutive patients

Dual Chamber Pacemaker Implantation in Dogs with Atrioventricular Block

Infections of electrophysiologic cardiac devices

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