Postoperative Infection with the Automatic Implantable Cardioverter Defibrillator: Clinical Presentation and Use of the Gallium Scan in Diagnosis

Kelly, P. M.; Wallace, Sandra; Tucker, Bernard L.; Hurvitz, Richard J.; Ilvento, Joseph P.; Mirabel, Gloria S.; Cannom, David S.

doi:10.1111/j.1540-8159.1988.tb03975.x

Cited by 38 publications

(8 citation statements)

References 10 publications

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“…Infection rates of pacemaker systems range from 0.6% to 3.9% according to retrospective and prospective studies. 6,[8][9][10][11] Of the 191 patients implanted with pacemakers at our institute between February 2004 and June 2009, including 123 new implantations and 68 generator exchanges, only two had pacemakers that became infected (1.0%). The most common signs and symptoms of pacemaker infection are fever, pocket erythema, and local pain.…”

Section: Discussionmentioning

confidence: 99%

Vacuum-Assisted Wound Closure for Pacemaker Infection

Sato

Onoe

2010

Pacing and Clinical Electrophysiology

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Section: Discussionmentioning

confidence: 99%

Vacuum-Assisted Wound Closure for Pacemaker Infection

Sato

Onoe

2010

Pacing and Clinical Electrophysiology

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“…If severe infectious conditions such as endocarditis are suspected in such patients, transesophageal echocardiography is recommended for a valvular evaluation prior to any lead-sparing procedures [ 19 ]. Furthermore, we believe that complete explantation of the entire ICED is required if fulminant mediastinitis is evident, either clinically or radiographically [ 2 17 22 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…The classic recommendation for the treatment of infected ICEDs is complete removal of the infected ICED and reinsertion at a new site. To date, explantation of the entire device—including patches, leads, and generators—and transpositioning it to a new pocket has been considered the safest treatment method for infected ICEDs [ 1 2 ].…”

Section: Introductionmentioning

confidence: 99%

Safe and Simplified Salvage Technique for Exposed Implantable Cardiac Electronic Devices under Local Anesthesia

Jung

Kim

et al. 2017

Arch Plast Surg

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BackgroundSkin erosion is a dire complication of implantable cardiac pacemakers and defibrillators. Classical treatments involve removal of the entire generator and lead systems, however, these may result in fatal complications. In this study, we present our experience with a simplified salvage technique for exposed implantable cardiac electronic devices (ICEDs) without removing the implanted device, in an attempt to reduce the risks and complication rates associated with this condition.MethodsThe records of 10 patients who experienced direct ICED exposure between January 2012 and December 2015 were retrospectively reviewed. The following surgical procedure was performed in all patients: removal of skin erosion and capsule, creation of a new pocket at least 1.0–1.5 cm inferior to its original position, migration of the ICED to the new pocket, and insertion of closed-suction drainage. Patients with gross local sepsis or septicemia were excluded from this study.ResultsSeven patients had cardiac pacemakers and the other 3 had implantable cardiac defibrillators. The time from primary ICED placement to exposure ranged from 0.3 to 151 months (mean, 29 months. Postoperative follow-up in this series ranged from 8 to 31 months (mean follow-up, 22 months). Among the 10 patients, none presented with any signs of overt infection or cutaneous lesions, except 1 patient with hematoma on postoperative day 5. The hematoma was successfully treated by surgical removal and repositioning of the closed-suction drainage.ConclusionsBased on our experience, salvage of exposed ICEDs is possible without removing the device in selected patients.

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“…Nuclear medicine imaging techniques have been applied to evaluate suspected or ascertained CIED infection altought the level of evidence of the published remains relatively low (Level II, class C) [151]. 67 Ga-citrate scan has been successfully employed in CIED infection [5,221,222]. Radiolabaled WBC scintigraphy helps to define the presence and the extent of CIED infection [5,[223][224][225][226].…”

Section: Cardiovascular Implantable Electronic Devicesmentioning

confidence: 99%

Current Status of Molecular Imaging in Infections

Sollini

Lauri²,

Boni

et al. 2018

CPD

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There is an increased need to find non-invasive tools for early diagnosis and follow-up of infections. Nuclear medicine techniques may be used to diagnose, localize and evaluate the severity and the extent of infections before the occurrence of anatomical abnormalities. This review focuses on different approaches based on radiolabelled cells, peptides and antibodies or [18F]FDG to image infective diseases in agreement with what is being jointly evaluated by the European Association of Nuclear Medicine (EANM). This is particularly relevant, since the EANM has strated a wide program of collaboration with other European clinical societies to define common diagnostic flow-charts in many of these infective diseases. It emerges the role of radiolabelled WBC by SPECT/CT for prosthetic joint infections and of FDG by PET/CT for spondylodiscitis. Comparable values of accuracy have been described for WBC and FDG in the diagnosis of vascular fgraft infections, diabetic gfoot, endocarditis and peripheral bone osteomyelitis, with some exceptions.

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Postoperative Infection with the Automatic Implantable Cardioverter Defibrillator: Clinical Presentation and Use of the Gallium Scan in Diagnosis

Cited by 38 publications

References 10 publications

Vacuum-Assisted Wound Closure for Pacemaker Infection

Vacuum-Assisted Wound Closure for Pacemaker Infection

Safe and Simplified Salvage Technique for Exposed Implantable Cardiac Electronic Devices under Local Anesthesia

Current Status of Molecular Imaging in Infections

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