Incidence and risk factors for cardiac implantable electronic device infection in current clinical settings in a Japanese population: A 20-year single-center observational study

Abstract

Cardiac implantable electronic devices (CIED), which include pacemakers (PM), implantable cardioverter defibrillators (ICD), and cardiac resynchronization therapy with a PM or defibrillator (CRTP/ CRTD), constitute major therapeutic options for brady-and tachyarrhythmia [1,2]. The rate of CIED implantation has been increasing worldwide in response to the general ageing of the population, as well as an expansion of indications for CIED implantation [3][4][5]. With this increasing rate of CIED implantation, the incidence of CIED infection has also been rising [4][5][6][7]; these infections have high mortality rates [8], increase the health-related financial burden [4,6,9], and require additional invasive therapies such as percutaneous lead extraction [10,11]. Therefore, there is a need to better understand the etiology of CIED infections. Hence, most studies reporting on the long-term

Predictors of Long-Term Infections After Cardiac Implantable Electronic Device Surgery ― Utility of Novel PADIT and PACE DRAP Scores ―

“…11,21 Furthermore, prior reports are limited to data obtained from patients with CDI and system removal, but older patients treated conservatively were not often enrolled. 3,4 Our study indicated that procedure duration longer than 1 h is an independent CDI risk factor. It is suggested that longer operating time is related to bacterial contamination.…”

“…The median SPH volume in CDI patients was 193.6 cm 3 (IQR: 327.6-367.2 cm 3 ), while in patients without infection the median SPH volume was 114.8 cm 3 (IQR: 96.7-164.7 cm 3 ). The great majority of SPHs (9/11) in CDI patients had an estimated volume >200 cm 3 , whereas in the no-CDI patients the estimated volume of SPHs was most frequently <200 cm 3 (29/36). Detailed data regarding SPH volume are shown in Table 4.…”

“…1,2 The reported CDI occurrence varies between 0.68% and 2.2% of CIED procedures, with significantly higher CDI incidence for implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy (CRT) procedures (up to 4.8%). [2][3][4][5] Previous studies report several patient-related and procedure-related risk factors for CDI development, but many of them were retrospective analyses with inconsistent CDI definitions. 4,6,7 Moreover, only a few of the previous reports focus on ICD or CRT recipients particularly.…”

Association Between Atrial High-Rate Episodes and Ischemic/Major Bleeding Events in Patients With a Cardiac Implantable Electronic Device ― A 10-Year, Single-Center Historical Cohort Study ―

“…Data collection and enrollment of patients were performed by reviewing the electronic medical records, as previously described. 12 Consecutive patients who underwent CIEDrelated procedures in the cardiac catheterization laboratory between October 2009 and September 2019 were enrolled. Patients who underwent multiple procedures during the study period were considered only for the initial procedure.…”

“…De novo procedures were related to the first implantation, whereas exchange involved a simple generator change, and revision was for correcting generator/lead position, hematoma evacuation, and implanting additional leads (atrial, right/left ventricular, or defibrillation leads), as previously described. 12 AHRE was defined as an atrial arrhythmia of >175 beats/min. 5,6, 13 Based on the maximum AHRE burden during the entire follow-up period, we classified the patients into 3 groups: (1) <6 min, (2) ≥6 min to 24 h, or (3) ≥24 h. The basis of using AHRE burden for dividing each group was established in a previous study.…”