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MINERVA CARDIOANGIOLOGICA

Rivista sulle Malattie del Cuore e dei Vasi


Official Journal of the Italian Society of Angiology and Vascular Pathology
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Minerva Cardioangiologica 2018 Jan 05

DOI: 10.23736/S0026-4725.18.04497-3

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Redo procedures and chronic renal dysfunction are associated with higher risk of cardiac electronic device infections

Giovanni MORANI, Giacomo MUGNAI , Bruna BOLZAN, Martina MOROSATO, Luca TOMASI, Sara FERRARI, Corrado VASSANELLI

Electrophysiology Unit, Division of Cardiology, University Hospital of Verona, Verona, Italy


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BACKGROUND: Infection is a major complication of pacemaker (PM) and implantable cardioverter-defibrillator (ICD) implantation. The present study sought to analyse the incidence rate of device infections, to investigate possible relationships between first implantations/repeated procedures and infection rates, and to identify some main risk factors associated with infection of cardiac implantable electronic devices (CIED).
METHODS: In a single center retrospective observational study, records of 3899 consecutive patients having undergone PM and ICD implantation, cardiac resynchronization therapy (CRT) or revision (device/lead replacements or upgrades) and between 2002 and 2012 were obtained.
RESULTS: Over a mean follow-up period of 66 ± 14 months, a total of 50 patients were identified as having CIED infection (0.85% per procedure and 1.28% per patient). Chronic renal dysfunction and repeated procedures were independently associated with higher risk of CIED infection on multivariate analysis (respectively, OR 1.30, 1.16-1.57 95%CI, p <0.0001; OR 1.23, 1.12-1.42 95%CI, p <0.0001). Staphylococcal species was responsible for the bulk of CIED infections (70% of all positive cultures). Coagulase-negative staphylococci were found more frequently than staphylococcus aureus (30% vs 12%).
CONCLUSIONS: The infection rate after cardiac electronic device procedures was low over the follow-up period. Repeated procedures and chronic renal dysfunction were associated with higher risk of CIED infection. Staphylococcal species were mainly responsible for device infections.


KEY WORDS: Cardiovascular implantable electronic device - Infection - Pacemaker - ICD - Risk factors

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Publication History

Article first published online: January 5, 2018
Manuscript accepted: January 3, 2018
Manuscript revised: November 8, 2017
Manuscript received: August 11, 2017

Per citare questo articolo

Morani G, Mugnai G, Bolzan B, Morosato M, Tomasi L, Ferrari S et al. Redo procedures and chronic renal dysfunction are associated with higher risk of cardiac electronic device infections. Minerva Cardioangiol 2018 Jan 05. DOI: 10.23736/S0026-4725.18.04497-3

Corresponding author e-mail

mugnai.giacomo@gmail.com