Positron emission tomography in patients with suspected pacing system infections may play a critical role in difficult cases

Ploux, Sylvain; Rivière, Annalisa; Amraoui, Sana; Whinnett, Zachary I.; Barandon, Laurent; Lafitte, Stéphane; Ritter, Philippe; Papaioannou, Georgios; Clémenty, Jacques; Jaı̈s, Pierre; Bordenave, Laurence; Haı̈ssaguerre, Michel; Bordachar, Pierre

doi:10.1016/j.hrthm.2011.03.062

Cited by 106 publications

(72 citation statements)

References 9 publications

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“…The diagnostic accuracy of [ 18 F]FDG PET/CT for lead infections is, however, lower (sensitivity 24-100%, specificity 79-100%) [12]. Such a finding is mainly related to the small size of the vegetations along the leads, which are often under the spatial resolution of the system [20]. [ 18 F]FDG PET/CT in association with Duke criteria also allowed reclassifying most of cases initially classified as¨possible¨IE [18].…”

Section: Cardiac Device-related Iementioning

confidence: 99%

Radionuclide Imaging of Infective Endocarditis: State of Art and Future Perspective

Marchetta

Withofs

Erba

et al. 2017

Curr Cardiovasc Imaging Rep

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Purpose of Review Infectious endocarditis is a serious disease requiring rapid diagnosis and accurate risk stratification to offer the best therapeutic strategy. Infection of prosthetic valve (PV) and cardiovascular implantable electronic device (CIED) is increasing due to the ageing of the population and the growing number of implants. Foreign material infection remains clinically challenging given the limitation of ultrasound techniques in this context whereas the diagnosis must be precocious. Recent Findings 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ([ 18 F]FDG PET/CT) and radiolabelled leukocytes single-photon emission computed tomography/computed tomography (SPECT/CT) are commonly used for this purpose.Summary In the present article, we summarized the available evidence for the use of nuclear imaging for the evaluation of infectious endocarditis.

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Section: Cardiac Device-related Iementioning

confidence: 99%

Radionuclide Imaging of Infective Endocarditis: State of Art and Future Perspective

Marchetta

Withofs

Erba

et al. 2017

Curr Cardiovasc Imaging Rep

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“…26 Protez kapak veya İK cihaz enfeksiyonu tanı-sında 18 F-floro-deoksiglikoz (FDG)-PET/BT kullanılarak pek çok çalışma yapılmıştır. 23,24,[27][28][29] Protez kapaklı 72 hastalık bir çalışmada, Duke kriterlerine, anormal FDG tutulumun eklenmesiyle duyarlılık %70'den %97'ye çıkmıştır. Daha önemlisi, Duke kriterlerine göre, muhtemel PKE tanısı alan hastaların %43'ünde endokardit tanısı kesinleştirilmiş veya dışlanmıştır.…”

Section: Manyeti̇k Rezonans Görüntülemeunclassified

“…Diğer dört hastanın izleminde ise aktif EE bulgusu saptanmamıştır. 28 Benzer olarak, İK cihaz enfeksiyon kuşkusu olan 66 hastada PET/BT ile enfeksiyon %89 duyarlılık ve %86 özgüllükle saptan- mıştır. Ayrıca, yüzeyel enfeksiyon, derin cep enfeksiyonundan ayırt edilebilmiştir.…”

Section: Manyeti̇k Rezonans Görüntülemeunclassified

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Infective Endocarditis: Diagnosis, Treatment and Prevention: Review

Doğan¹,

Gürbüz²

2016

Turkiye Klinikleri J Cardiovasc Sci

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“…In a pilot study of patients with suspected pacing system infections, PET scanning revealed lead infection in six out of 10 patients. 27 Another study aimed at assessing the diagnostic yield of FDG-PET/CT in patients with cardiac CIED infection showed that the sensitivity and specificity of PET were 86.7 % (59.5-98.3, 95 % CI) and 100.0 % (42.1-100, 95 % CI), respectively, in patients with pocket site infection and 30.8 % (9.1-61.4, 95 % CI) and 62.5 % (24.5-91.5, 95 % CI), respectively, in patients with cardiac device-related infective endocarditis. 28 FDG-PET/CT has also been useful for distinguishing CIED infection from recent post-implant changes and for guiding therapy.…”

Section: Lead-related Vegetations Is Greater Than Transthoracic Echocmentioning

confidence: 99%

Management of Cardiac Implantable Electronic Device Infection

Podoleanu

Deharo

2014

Arrhythm Electrophysiol Rev

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The increasing use of cardiac implantable electronic devices (CIEDs) for management of cardiac conditions has over the last few years been associated with higher infection rates.1 Expanded CIED use alone cannot account for this rise, 2-4 which involves both patient-and device-related factors. Indeed patients are tending to be older and presenting with co-morbidities, while devices are becoming more sophisticated and requiring more leads and revision. 6 In terms of patient demographics, the occurrence of CIED infection was greatest in white males over 65 years of age, and the most significant associated co-morbidities were renal failure, respiratory failure, heart failure and diabetes. The greatest risk factors for mortality were respiratory failure (odds ratio [OR] 13.58; 95 % confidence interval [CI] 12.88-14.3), renal failure (OR 4.28; 95 % CI 4.04-4.53) and heart failure (OR 2.71; 95 % CI 2.54-2.88). Post-operative haematoma was more frequent in patients who developed infection. Sites reporting higher infection rates had sicker patients and lower overall procedure volumes. AbstractDespite improved preventive measures, infection associated with the use of cardiac implantable electronic devices (CIEDs) to treat often life-threatening conditions is rising at an average annual rate of almost 5 %. This rise is being driven by the increasing complexity of CIED technology and by the advancing age and co-morbidities of the patients. Although CIED infection is usually suspected based on local signs at the generator pocket site, diagnosis can be challenging in patients presenting no local manifestations or symptoms. Diagnostic methods include microbiological testing and echocardiography, and may be completed by positron emission tomography (PET)/computed tomography (CT) scan in selected cases. CIED infection requires a multidisciplinary approach in view of hardware extraction, targeted antibiotic therapy and reimplantation on an as-needed basis. Antibiotic prophylaxis targeting staphylococcal flora is recommended but the relation of these infections to medical care exposes patients to multi-resistant bacteria. New preventive measures utilising an antibacterial sleeve look promising. Treatment can be started on an empirical basis using an antistaphylococcal agent but must be continued using targeted antibiotic therapy. Crucial questions remain as to the best prevention strategy, optimal duration and timing of antibiotic therapy, and the most effective reimplantation technique.

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Positron emission tomography in patients with suspected pacing system infections may play a critical role in difficult cases

Cited by 106 publications

References 9 publications

Radionuclide Imaging of Infective Endocarditis: State of Art and Future Perspective

Radionuclide Imaging of Infective Endocarditis: State of Art and Future Perspective

Infective Endocarditis: Diagnosis, Treatment and Prevention: Review

Management of Cardiac Implantable Electronic Device Infection

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