The Impact of Povidone‐Iodine Pocket Irrigation Use on Pacemaker and Defibrillator Infections

Lakkireddy, Dhanunjaya; Valasareddi, Srilaxmi; Ryschon, Kay; Basarkodu, Krishnamohan; Rovang, Karen; Mohiuddin, Syed M.; Hee, Tom; Schweikert, Robert A.; Tchou, Patrick; Wilkoff, Bruce L.; Natale, Andrea; Li, Huagui

doi:10.1111/j.1540-8159.2005.00173.x

Cited by 69 publications

(25 citation statements)

References 24 publications

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“…In their meta-analysis Darouiche Pocket irrigation with povidone-iodine however did not have a significant effect on DRI in a small study. 96 Irrigation of the pocket with saline probably reduces the bacterial concentration, though there is no evidence to indicate that it reduces DRI.…”

Section: Peri-operative Antibiotic Prophylaxismentioning

confidence: 98%

Preventing cardiac implantable electronic device infections

Padfield¹,

Steinberg²,

Bennett³

et al. 2015

Heart Rhythm

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Section: Peri-operative Antibiotic Prophylaxismentioning

confidence: 98%

Preventing cardiac implantable electronic device infections

Padfield¹,

Steinberg²,

Bennett³

et al. 2015

Heart Rhythm

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“…So far only one uncontrolled study has addressed this question, and after 1 to 3 months no improvement was seen. A large body of evidence shows that chronic heart failure (CHF) affects skeletal muscle functional capacity and metabolic status (like increased insulin resistance [3]), which in turn contribute to patient symptoms. Information on changes of these parameters with CRT would be relevant in order to shed more light on the mechanisms of CRT-related improvement of symptomatic status.…”

Section: Questions In Cardiac Resynchronization Therapy: Metabolic Immentioning

confidence: 99%

“…Our data illustrate a dramatic rise in CRMD infection beginning in Tachycardia Trial) were being digested and accepted by the scientific community. It remains unsettled, however, whether ICDs confer a higher infection risk than PMs (3,4). An indirect effect of expanding ICD indications could be an increased proportion of implantation by low volume operators or facilities, a factor that has been linked to higher rates of mechanical complications and infections (5).…”

mentioning

confidence: 99%

Rising Rates of Cardiac Rhythm Management Device Infections in the United States: 1996 through 2003

Voigt¹,

Shalaby²,

Saba³

2006

Journal of the American College of Cardiology

348

243

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To the Editor: Clinical indications for cardiac rhythm management devices (CRMDs) have expanded dramatically. The impact of this expansion upon rates of CRMD infection, a complication of device therapy that often requires system explantation (1), has not been clearly defined.We hypothesized that the current growth in implantable cardioverter defibrillator (ICD) utilization would impact rates of CRMD infection, both by expanding and changing the demographics of the population at risk. We analyzed a nationally representative database to compare trends in rates of new CRMD implants with rates of hospitalization for CRMD infection. We also sought to define the rates of in-hospital mortality associated with such events.We collected files from the National Hospital Discharge Survey (NHDS) from 1996 to 2003. Cases with a primary discharge diagnosis of pacemaker (PM) or ICD infection (International Classification of Diseases-9th Revision-Clinical Modification [ICD-9-CM] code 996.61) were identified. In addition, patients with device explantation (ICD-9-CM codes 37.77, 37.79, 37.89, or 37.99) and a primary discharge diagnosis of sepsis (ICD-9-CM code 038 or 785.59), bacteremia (ICD-9-CM code 790.7), endocarditis (ICD-9-CM codes 421.0, 421.9, or 424.90), cellulitis (ICD-9-CM code 682.9), or fever (ICD-9-CM code 780.6) were defined as having CRMD infection. New CRMD implantations were identified by ICD-9-CM procedural codes 377.0 to 377.6.In order to determine the clinical predictors for in-hospital mortality among patients with CRMD infection, a control group with previously implanted PM or ICD who did not have CRMD infection was identified. This much larger group included patients with PM or ICD in situ (ICD-9-CM codes V45.01 or V45.02, respectively) who were discharged with diagnoses other than CRMD infection. Demographic factors were recorded. Other characteristics were identified, including presence of diabetes (ICD-9-CM codes 250.00 to 250.02 or 250.70 to 250.72), renal failure (ICD-9-CM codes 585, 593.9, or V56.0), and hospital size.Univariate analysis was performed using 1-way analysis of variance for continuous variables and the chi-square test for categoric variables. Multivariate analysis using a binary logistic regression test was undertaken to determine the independent predictors of in-hospital mortality. Cases were weighed using the "weight" variable for derivation of national estimates according to

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“…Her ne kadar cep enfeksiyonları ile ilgili patogenetik mekanizmalar henüz net bilinmemekle beraber klinik deneyimleri olan merkezlerin izlemleri ve uzman görüşü olarak pacemaker cep enfeksiyonları için risk faktörlerini şu şekilde değerlendirebiliriz (1)(2)(3)(4)(5) …”

Section: Discussionunclassified

Rare complication of permanent pacemaker: protrusion of the battery connected to the pacemaker pocket infection

Ercan¹,

Sucu²,

Yavuz³

et al. 2013

Gaziantep Med J

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ÖzetPacemaker cep enfeksiyonu son zamanlarda kalıcı pacemaker, kardiyak resenkronizasyon tedavi ve implante edilebilir kardiyoverter defibrilatör (ICD) endikasyon yelpazesinin genişlemesiyle giderek artacak bir problem olarak görülmektedir. İskemik kardiyomiyopati tanısıyla 2008 yılında ICD yerleştirilen yetmiş dört yaşındaki erkek hastada pacemaker cep enfeksiyonu sonrası, bataryanın ciltten protrüde olduğu görüldü. 4 hafta süren antibiyotik tedavi sonrası cerrahi olarak tüm pacemaker ekipmanları çıkarıldı. Pacemaker cep enfeksiyonu risk faktörlerinin varlığında daha sık gelişmekte, komplike olarak uzun süre antibiyotik kullanımı ve cerrahi tedavi gerektirmektedir. Anahtar kelimeler: Cep enfeksiyonu; pacemaker; protrüzyon. AbstractPacemaker pocket infection will recently increasingly be seen as a problem related to expanding range of indications of the permanent pacemaker, cardiac resynchronization therapy, implantable cardioverter defibrillator (ICD). Seventy-four-year-old male patient with ICD implanted in 2008 due to ischemic cardiomyopathy, who had the pacemaker battery protruding from the skin after pacemaker pocket infection. After 4 weeks of antibiotic therapy, all pacemaker equipment removed by surgery. Pacemaker pocket infection developed more frequently in the presence of risk factors, needs long-term use of antibiotics, and surgical treatment as complicated.

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The Impact of Povidone‐Iodine Pocket Irrigation Use on Pacemaker and Defibrillator Infections

Abstract: Povidone-iodine irrigation of the subcutaneous pocket did not alter the rates of pocket infection after pacemaker/defibrillator implantation.

Cited by 69 publications

References 24 publications

Preventing cardiac implantable electronic device infections

Preventing cardiac implantable electronic device infections

Rising Rates of Cardiac Rhythm Management Device Infections in the United States: 1996 through 2003

Rare complication of permanent pacemaker: protrusion of the battery connected to the pacemaker pocket infection

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