scholarly journals Clinical practice and implementation of guidelines for the prevention, diagnosis and management of cardiac implantable electronic device infections: results of a worldwide survey under the auspices of the European Heart Rhythm Association

EP Europace ◽  
2019 ◽  
Vol 21 (8) ◽  
pp. 1270-1279 ◽  
Author(s):  
Vassil Traykov ◽  
Maria Grazia Bongiorni ◽  
Giuseppe Boriani ◽  
Haran Burri ◽  
Roberto Costa ◽  
...  
Keyword(s):  
Preventive Measures ◽  
Electronic Device ◽  
Heart Rhythm ◽  
Initial Step ◽  
Needle Aspiration ◽  
Further Education ◽  
Cardiac Implantable Electronic Device ◽  
Infection Rates ◽  
Clinical Practices ◽  
Diagnosis And Management

Abstract Aims Cardiac implantable electronic device (CIED) infection rates are increasing. Worldwide compliance and disparities to published guidelines for the prevention, diagnosis and management of these conditions are not well elucidated. The purpose of this survey, therefore, was to clarify these issues through an inquiry to arrhythmia-related associations and societies worldwide. Methods and results A questionnaire comprising 15 questions related to CIED infections was distributed among members of seven arrhythmia societies worldwide. A total of 234 centres in 62 countries reported implantation rates of which 159 (68.0%) performed more than 200 device implantations per year and 14 (6.0%) performed fewer than 50 implantations per year. The reported rates of CIED infections for 2017 were ≤2% in 78.7% of the centres, while the infection rates exceeded 5% in 7.8% of the centres. Preventive measures for CIED infection differed from published recommendations and varied among different regions mainly in terms of pocket irrigation and administering post-operative antimicrobial therapy the use of which was reported by 39.9% and 44% of the respondents, respectively. Antibacterial envelopes were used by 37.7% of the respondents in selected circumstances. In terms of pocket infection management, 62% of the respondents applied complete system removal as an initial step. Diagnostic pocket needle aspiration and pocket surgical debridement were reported by 15.8% and 11.8% of centres, respectively. Conclusion Clinical practices for prevention and management of CIED do not fully comply with current recommendations and demonstrate considerable regional disparities. Further education and programmes for improved implementation of guidelines are mandatory.

scholarly journals European Heart Rhythm Association (EHRA) international consensus document on how to prevent, diagnose, and treat cardiac implantable electronic device infections—endorsed by the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS), the Latin American Heart Rhythm Society (LAHRS), International Society for Cardiovascular Infectious Diseases (ISCVID) and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)

EP Europace ◽  
2019 ◽  
Vol 22 (4) ◽  
pp. 515-549 ◽  
Author(s):  
Carina Blomström-Lundqvist ◽  
Vassil Traykov ◽  
Paola Anna Erba ◽  
Haran Burri ◽  
Jens Cosedis Nielsen ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Latin American ◽  
Electronic Device ◽  
Heart Rhythm ◽  
Asia Pacific ◽  
Cardiac Resynchronization ◽  
Cardiac Implantable Electronic Device ◽  
International Consensus ◽  
Consensus Document ◽  
Cardiac Resynchronization Therapy Devices

Abstract Pacemakers, implantable cardiac defibrillators, and cardiac resynchronization therapy devices are potentially life-saving treatments for a number of cardiac conditions, but are not without risk. Most concerning is the risk of a cardiac implantable electronic device (CIED) infection, which is associated with significant morbidity, increased hospitalizations, reduced survival, and increased healthcare costs. Recommended preventive strategies such as administration of intravenous antibiotics before implantation are well recognized. Uncertainties have remained about the role of various preventive, diagnostic, and treatment measures such as skin antiseptics, pocket antibiotic solutions, anti-bacterial envelopes, prolonged antibiotics post-implantation, and others. Guidance on whether to use novel device alternatives expected to be less prone to infections and novel oral anticoagulants is also limited, as are definitions on minimum quality requirements for centres and operators and volumes. Moreover, an international consensus document on management of CIED infections is lacking. The recognition of these issues, the dissemination of results from important randomized trials focusing on prevention of CIED infections, and observed divergences in managing device-related infections as found in an European Heart Rhythm Association worldwide survey, provided a strong incentive for a 2019 International State-of-the-art Consensus document on risk assessment, prevention, diagnosis, and treatment of CIED infections.

scholarly journals Practices of cardiac implantable electronic device follow-up: results of the European Heart Rhythm Association survey

EP Europace ◽  
2012 ◽  
Vol 14 (3) ◽  
pp. 423-425 ◽  
Author(s):  
G. Marinskis ◽  
L. van Erven ◽  
M. G. Bongiorni ◽  
G. Y. H. Lip ◽  
L. Pison ◽  
...  
Keyword(s):  
Electronic Device ◽  
Heart Rhythm ◽  
Cardiac Implantable Electronic Device

scholarly journals European Heart Rhythm Association (EHRA) international consensus document on how to prevent, diagnose, and treat cardiac implantable electronic device infections—endorsed by the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS), the Latin American Heart Rhythm Society (LAHRS), International Society for Cardiovascular Infectious Diseases (ISCVID) and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)

2019 ◽  
Vol 57 (1) ◽  
pp. e1-e31 ◽  
Author(s):  
Carina Blomström-Lundqvist ◽  
Vassil Traykov ◽  
Paola Anna Erba ◽  
Haran Burri ◽  
Jens Cosedis Nielsen ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Latin American ◽  
Electronic Device ◽  
Heart Rhythm ◽  
Asia Pacific ◽  
Cardiac Resynchronization ◽  
Cardiac Implantable Electronic Device ◽  
International Consensus ◽  
Consensus Document ◽  
Cardiac Resynchronization Therapy Devices

Abstract Pacemakers, implantable cardiac defibrillators, and cardiac resynchronization therapy devices are potentially life-saving treatments for a number of cardiac conditions, but are not without risk. Most concerning is the risk of a cardiac implantable electronic device (CIED) infection, which is associated with significant morbidity, increased hospitalizations, reduced survival, and increased healthcare costs. Recommended preventive strategies such as administration of intravenous antibiotics before implantation are well recognized. Uncertainties have remained about the role of various preventive, diagnostic, and treatment measures such as skin antiseptics, pocket antibiotic solutions, anti-bacterial envelopes, prolonged antibiotics post-implantation, and others. Guidance on whether to use novel device alternatives expected to be less prone to infections and novel oral anticoagulants is also limited, as are definitions on minimum quality requirements for centres and operators and volumes. Moreover, an international consensus document on management of CIED infections is lacking. The recognition of these issues, the dissemination of results from important randomized trials focusing on prevention of CIED infections, and observed divergences in managing device-related infections as found in an European Heart Rhythm Association worldwide survey, provided a strong incentive for a 2019 International State-of-the-art Consensus document on risk assessment, prevention, diagnosis, and treatment of CIED infections.

Variations in cardiac implantable electronic device surveillance and ancillary testing in the paediatric and congenital heart disease population: an international multi-centre survey from the Paediatric and Congenital Electrophysiology Society

2021 ◽  
pp. 1-5
Author(s):  
Melissa M. Olen ◽  
Brynn E. Dechert ◽  
Anne Foster ◽  
Ronald J. Kanter ◽  
Michael J. Silka ◽  
...  
Keyword(s):  
Remote Monitoring ◽  
Electronic Device ◽  
Stress Test ◽  
Exercise Stress Test ◽  
Exercise Stress ◽  
Implantable Cardioverter Defibrillators ◽  
Cardiac Implantable Electronic Device ◽  
Clinical Practices ◽  
Device Implantation

Abstract Background: Expert guidance from scientific societies and regulatory agencies recommend a framework of principles for frequency of in-person evaluations and remote monitoring for patients with cardiac implantable electronic devices. However, there are limited data regarding adherence to recommendations among paediatric electrophysiologists, and there are no data regarding cardiac implantable electronic device-related ancillary testing. Methods: To assess current clinical practices for cardiac implantable electronic device in-person evaluation, remote monitoring, and cardiac implantable electronic device-related ancillary testing, the Paediatric and Congenital Electrophysiology Society members were surveyed. The main outcome measures were variations in frequency of in person evaluation, frequency of remote monitoring, and cardiac implantable electronic device-related ancillary testing. Results: All respondents performed in-person evaluation at least once a year, but <50% of respondents performed an in-person evaluation within 2 weeks of cardiac implantable electronic device implantation. Remote monitoring was performed every 3 months for pacemakers and implantable cardioverter defibrillators by 71 and 75% respondents, respectively. Follow-up echocardiography was performed every 2–3 years by 53% respondents for patients with >50% ventricular pacing. Majority of respondents (75%) did not perform either an exercise stress test or ambulatory Holter monitoring or chest X-ray (65%) after cardiac implantable electronic device implantation. Conclusion: This survey identified significant practice variations in cardiac implantable electronic device in- person evaluation, remote monitoring, and ancillary testing practices among paediatric electrophysiologists. Cardiac implantable electronic device management may be optimised by development of a paediatric-specific guidelines for follow-up and ancillary testing.

scholarly journals A survey of cardiac implantable electronic device implantation in India: By Indian Society of Electrocardiology and Indian Heart Rhythm Society

2016 ◽  
Vol 68 (1) ◽  
pp. 68-71 ◽  
Author(s):  
Jayaprakash Shenthar ◽  
Shomu Bohra ◽  
Vinay Jetley ◽  
Amit Vora ◽  
Yash Lokhandwala ◽  
...  
Keyword(s):  
Electronic Device ◽  
Heart Rhythm ◽  
Indian Society ◽  
Cardiac Implantable Electronic Device ◽  
Device Implantation

scholarly journals European Heart Rhythm Association (EHRA) international consensus document on how to prevent, diagnose, and treat cardiac implantable electronic device infections—endorsed by the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS), the Latin American Heart Rhythm Society (LAHRS), International Society for Cardiovascular Infectious Diseases (ISCVID), and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)

2020 ◽  
Vol 41 (21) ◽  
pp. 2012-2032 ◽  
Author(s):  
Carina Blomström-Lundqvist ◽  
Vassil Traykov ◽  
Paola Anna Erba ◽  
Haran Burri ◽  
Jens Cosedis Nielsen ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Latin American ◽  
Electronic Device ◽  
Heart Rhythm ◽  
Asia Pacific ◽  
Cardiac Implantable Electronic Device ◽  
International Consensus ◽  
Consensus Document ◽  
Consensus Statements ◽  
Post Implantation

Abstract Pacemakers, implantable cardiac defibrillators, and cardiac resynchronization therapy devices are potentially lifesaving treatments for a number of cardiac conditions but are not without risk. Most concerning is the risk of a cardiac implantable electronic device (CIED) infection, which is associated with significant morbidity, increased hospitalizations, reduced survival, and increased health care costs. Recommended preventive strategies such as administration of intravenous antibiotics before implantation are well-recognized. Uncertainties have remained about the role of various preventive, diagnostic, and treatment measures such as skin antiseptics, pocket antibiotic solutions, antibacterial envelopes, prolonged antibiotics post-implantation, and others. When compared with previous guidelines or consensus statements, the present consensus document gives guidance on the use of novel device alternatives, novel oral anticoagulants, antibacterial envelopes, prolonged antibiotics post-implantation, as well as definitions on minimum quality requirements for centres and operators and volumes. The recognition that an international consensus document focused on management of CIED infections is lacking, the dissemination of results from new important randomized trials focusing on prevention of CIED infections, and observed divergences in managing device-related infections as found in an European Heart Rhythm Association worldwide survey, provided a strong incentive for a Novel 2019 International State-of-the-art Consensus document on risk assessment, prevention, diagnosis, and treatment of CIED infections.

scholarly journals Postimplantation pocket hematoma increases risk of cardiac implantable electronic device infection: A meta‐analysis

2021 ◽  
Author(s):  
Jakrin Kewcharoen ◽  
Chanavuth Kanitsoraphan ◽  
Sittinun Thangjui ◽  
Thiratest Leesutipornchai ◽  
Sakditad Saowapa ◽  
...  
Keyword(s):  
Electronic Device ◽  
Meta Analysis ◽  
Cardiac Implantable Electronic Device ◽  
Device Infection ◽  
Pocket Hematoma

scholarly journals Brucella cardiac implantable electronic device infection: A single-center case series

2021 ◽  
pp. 102568
Author(s):  
Fatehi Elzein ◽  
Eid Alsufyani ◽  
Yahya Al Hebaishi ◽  
Mohammed Mosaad ◽  
Moayad Alqurashi ◽  
...  
Keyword(s):  
Electronic Device ◽  
Case Series ◽  
Single Center ◽  
Cardiac Implantable Electronic Device ◽  
Device Infection

scholarly journals Resuming professional football (soccer) during the COVID-19 pandemic in a country with high infection rates: a prospective cohort study

2021 ◽  
pp. bjsports-2020-103724
Author(s):  
Yorck Olaf Schumacher ◽  
Montassar Tabben ◽  
Khalid Hassoun ◽  
Asmaa Al Marwani ◽  
Ibrahim Al Hussein ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Preventive Measures ◽  
Clinical Symptoms ◽  
Severe Illness ◽  
Football Players ◽  
Professional Football ◽  
Infection Rates ◽  
High Infection

ObjectivesThe risk of viral transmission associated with contact sports such as football (soccer) during the COVID-19 pandemic is unknown. The aim of this study was to describe the infective and immune status of professional football players, team staff and league officials over a truncated football season resumed at the height of the COVID-19 pandemic in a country with high infection rates and to investigate the clinical symptoms related to COVID-19 infection in professional football players.MethodsProspective cohort study of 1337 football players, staff and officials during a truncated football season (9 weeks) with a tailored infection control programme based on preventive measures and regular SARS-CoV-2 PCR swab testing (every 3–5 days) combined with serology testing for immunity (every 4 weeks). Clinical symptoms in positive participants were recorded using a 26-item, Likert-Scale-based scoring system.ResultsDuring the study period, 85 subjects returned positive (cycle threshold (cT) ≤30) or reactive (30<cT<40) PCR tests, of which 36 were players. The infection rate was consistent with that of the general population during the same time period. More than half of infected subjects were asymptomatic, and the remaining had only mild symptoms with no one requiring hospitalisation. Symptom severity was associated with lower cT values. Social contacts and family were the most common sources of infection, and no infection could be traced to training or matches. Of the 36 infected players, 15 presented positive serology during the study period.ConclusionFootball played outdoors involving close contact between athletes represents a limited risk for SARS-CoV-2 infection and severe illness when preventive measures are in place.

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