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Device infections related to cardiac resynchronization therapy in clinical practice-An analysis of its prevalence, risk factors and routine surveillance at a single center university hospital
- Source :
- Clinical Cardiology
- Publication Year :
- 2021
- Publisher :
- Uppsala universitet, Kardiologi-arrytmi, 2021.
-
Abstract
- Background The implantation rates of cardiac implantable electronic devices have steadily increased, accompanied by a steeper rise of device related infections (DRI). Hypothesis The prevalence of DRI for cardiac resynchronization therapy (CRT) is higher in clinical practice than reported previously, even at a university hospital, and likely higher than reported to the national device registry. Methods Electronic medical records of consecutive patients undergoing a CRT procedure between January 2016 and December 2017 were analyzed. Clinical history, procedure related variables and complications were reviewed by specialists in cardiology and infectious diseases. Results A total of 171 patients, mean aged 74 years, 138 males (80.7%) were included. Twelve DRI occurred in 10 patients during mean 2.5 years follow‐up, giving a prevalence of 7% (incidence of 29/1000 person‐years). Reoperation, pocket haematoma, ≥3 procedures, previous device infection and indwelling central venous line were the strongest predictive factors according to univariate analysis. Out of 63/171 (36.8%) major complications, 31(49.2%) were lead‐related. There were 49/171 (28.7%) reoperations and 15/171 (8.8%) minor complications. The number major complications and DRI reported to the national device registry were 7/171 (4.1%) and 2/171 (0.6%), respectively, reflecting a 5‐fold underreporting. Conclusions The high rate of CRT device infections is in sharp contrast to those reported by others and to the national device registry. Although a center specific explanation cannot be excluded, the high rates highlight a major issue with registries, reinforcing the need for better surveillance and automatic reporting of device related complications.
- Subjects :
- Male
medicine.medical_specialty
complications
medicine.medical_treatment
Cardiac resynchronization therapy
030204 cardiovascular system & hematology
Single Center
Cardiac Resynchronization Therapy
Hospitals, University
03 medical and health sciences
0302 clinical medicine
Risk Factors
medicine
Prevalence
Endocarditis
Humans
Cardiac and Cardiovascular Systems
030212 general & internal medicine
Cardiac Resynchronization Therapy Devices
device
pocket
Univariate analysis
Quality and Outcomes
Kardiologi
business.industry
pacemaker registry
Incidence (epidemiology)
Medical record
General Medicine
cardiac resynchronization
University hospital
medicine.disease
infection
Defibrillators, Implantable
Clinical Practice
Emergency medicine
endocarditis
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Clinical Cardiology
- Accession number :
- edsair.doi.dedup.....9779857ab3aca7f0f01c63fccc2d018b