Continued Rise in Rates of Cardiovascular Implantable Electronic Device Infections in the United States: Temporal Trends and Causative Insights

Voigt, Andrew; Shalaby, Alaa; Saba, Samir

doi:10.1111/j.1540-8159.2009.02569.x

Cited by 365 publications

(265 citation statements)

References 24 publications

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“…These devices are increasingly common in the United States, with estimated implant rates in patients with heart failure diagnoses or hospitalizations for sudden cardiac arrest ranging from 24% to 38% 1, 2, 3. For patients potentially eligible for CRT, CRT‐D devices appear to be the “default” device in the United States 4, 5.…”

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confidence: 99%

Geographic and Temporal Variation in Cardiac Implanted Electric Devices to Treat Heart Failure

Hatfield

Kramer

Volya

et al. 2016

JAHA

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BackgroundCardiac implantable electric devices are commonly used to treat heart failure. Little is known about temporal and geographic variation in use of cardiac resynchronization therapy (CRT) devices in usual care settings.Methods and ResultsWe identified new CRT with pacemaker (CRT‐P) or defibrillator generators (CRT‐D) implanted between 2008 and 2013 in the United States from a commercial claims database. For each implant, we characterized prior medication use, comorbidities, and geography. Among 17 780 patients with CRT devices (median age 69, 31% women), CRT‐Ps were a small and increasing share of CRT devices, growing from 12% to 20% in this study period. Compared to CRT‐D recipients, CRT‐P recipients were older (median age 76 versus 67), and more likely to be female (40% versus 30%). Pre‐implant use of β‐blockers and angiotensin‐converting enzyme inhibitors or angiotensin II receptor blockers was low in both CRT‐D (46%) and CRT‐P (31%) patients. The fraction of CRT‐P devices among all new implants varied widely across states. Compared to the increasing national trend, the share of CRT‐P implants was relatively increasing in Kansas and relatively decreasing in Minnesota and Oregon.ConclusionsIn this large, contemporary heart failure population, CRT‐D use dwarfed CRT‐P, though the latter nearly doubled over 6 years. Practice patterns vary substantially across states and over time. Medical therapy appears suboptimal in real‐world practice.

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confidence: 99%

Geographic and Temporal Variation in Cardiac Implanted Electric Devices to Treat Heart Failure

Hatfield

Kramer

Volya

et al. 2016

JAHA

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“…CRT implantation technology is also improving that will enable better pacing site selection [70][71][72]. Implantation-related complications remain a problem [14, 73,74] that future developments in lead technology and wireless electrodes may help overcome [75].…”

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confidence: 99%

Increasing knowledge and changing views in cardiac resynchronization therapy

Buga

Cleland

2011

Heart Fail Rev

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“…Despite advances in aseptic surgical techniques and prophylactic i.v. antibiotics, the incidence of these infections has remained at 1-5% (7,8), corresponding to ∼25,000 PJIs, 14,000 CIED infections, and 100,000 fracture-fixation device infections per year in the United States (1,7,8). Moreover, the number of these infections is rising dramatically along with the increasing clinical demand for these devices (8,9).…”

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confidence: 99%

Polymeric nanofiber coating with tunable combinatorial antibiotic delivery prevents biofilm-associated infection in vivo

Ashbaugh

Jiang

Zheng

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

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Bacterial biofilm formation is a major complication of implantable medical devices that results in therapeutically challenging chronic infections, especially in cases involving antibiotic-resistant bacteria.As an approach to prevent these infections, an electrospun composite coating comprised of poly(lactic-coglycolic acid) (PLGA) nanofibers embedded in a poly(e-caprolactone) (PCL) film was developed to locally codeliver combinatorial antibiotics from the implant surface. The release of each antibiotic could be adjusted by loading each drug into the different polymers or by varying PLGA:PCL polymer ratios. In a mouse model of biofilm-associated orthopedic-implant infection, three different combinations of antibiotic-loaded coatings were highly effective in preventing infection of the bone/joint tissue and implant biofilm formation and were biocompatible with enhanced osseointegration. This nanofiber composite-coating technology could be used to tailor the delivery of combinatorial antimicrobial agents from various metallic implantable devices or prostheses to effectively decrease biofilm-associated infections in patients.nanofiber | biofilm | infection | antibiotic | delivery

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Continued Rise in Rates of Cardiovascular Implantable Electronic Device Infections in the United States: Temporal Trends and Causative Insights

Cited by 365 publications

References 24 publications

Geographic and Temporal Variation in Cardiac Implanted Electric Devices to Treat Heart Failure

Geographic and Temporal Variation in Cardiac Implanted Electric Devices to Treat Heart Failure

Increasing knowledge and changing views in cardiac resynchronization therapy

Polymeric nanofiber coating with tunable combinatorial antibiotic delivery prevents biofilm-associated infection in vivo

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