Pacemaker infective endocarditis

Cacoub, Patrice; Leprince, Pascal; Nataf, Patrick; Hausfater, Pierre; Dorent, Richard; Wechsler, B.; Bors, V.; Pavie, Alain; Piette, Jean Charles; Gandjbakhch, I

doi:10.1016/s0002-9149(98)00365-8

Cited by 277 publications

(230 citation statements)

References 23 publications

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“…In contrast, the mortality rate in patients who had combined antibiotics and electrode removal was only 18% (range, 13% to 33%) in one literature review. 54 Another series also reported failure to remove an infected indwelling intra- vascular device to be associated with increased all-cause mortality. 50 Patients whose infected pacemaker or ICD was not removed had an almost 3-fold (47.6% versus 16.7%) increased risk of dying.…”

Section: Secondary Prophylaxismentioning

confidence: 99%

See 1 more Smart Citation

Nonvalvular Cardiovascular Device–Related Infections

Baddour¹,

Bettmann²,

Bolger³

et al. 2003

Circulation

447

326

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Section: Secondary Prophylaxismentioning

confidence: 99%

“…With regard to pacemakers, 13% to 52% of patients may no longer require pacing support. 40,54,55 Although antibiotics are frequently used as primary prophylaxis of pacemaker implantation, there are no large randomized, controlled trials to support this practice. A recent meta-analysis 58 reviewed 7 published prospective studies.…”

Section: Secondary Prophylaxismentioning

confidence: 99%

Nonvalvular Cardiovascular Device–Related Infections

Baddour¹,

Bettmann²,

Bolger³

et al. 2003

Circulation

447

326

View full text Add to dashboard Cite

“…Despite adequate treatment, reported death rates range from 8.0 % to 26.9 %. 4,5,17,[49][50][51][52] Several predictors of long-term mortality have been identified including older age, heart failure, infective endocarditis, renal failure and long-term corticosteroid therapy. 46,53 However, these high mortality rates must be seen in the context of populations with multiple co-morbidities.…”

Section: Discussionmentioning

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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“…(11,12) Blood cultures are positive in 77% of cases of PMIE. (3,4,7) Staphylococci are the most frequent pathogens. (7,9) It is important to note that Duke criteria are difficult to apply in these patients because of lower sensitivity.…”

Section: Discussionmentioning

confidence: 99%

“…(1,2) PMIE often presents with fever, weakness, and elevated inflammation markers, (1,3,4) while PMLT is usually an accidental echocardiographic finding, only occasionally presenting with right sided heart failure, rhythm disorder or pulmonary artery embolism. (2,5,6) Differences in clinical presentation, in addition to characteristic echocardiographic appearances and laboratory findings, are usually helpful in distinguishing the aforementioned entities with confidence.…”

Section: Introductionmentioning

confidence: 99%

Atypical presentation of thrombosis of a permanent pacemaker lead

2012

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Pacemaker infective endocarditis

Cited by 277 publications

References 23 publications

Nonvalvular Cardiovascular Device–Related Infections

Nonvalvular Cardiovascular Device–Related Infections

Management of Cardiac Implantable Electronic Device Infection

Atypical presentation of thrombosis of a permanent pacemaker lead

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