Abstract

Research Article

A study on pacemaker pocket infection

Goutam Datta*

Published: 25 March, 2020 | Volume 5 - Issue 1 | Pages: 056-059

Objective: Cardiac implantable electronic device (CIED) infections now constitute ∼ 10% of all endocarditis cases. The incidence of CIED infection is usually < 2%. Our objective was to study pacemaker pocket infection rate and different risk factors in our institution.

Methods: This observational study was conducted over a period of five years from January 2011 to December 2016 and it included 1096 patients. Common risk factors like patients with diabetes, repeat procedure, chronic renal failure, chronic obstructive airway disease, immunosuppressive agents were studied in our patients.

Results: Our study consisted of 1096 patients. Pacemaker pocket infection occurred in sixteen patients (1.5%). Chronic renal failure patients were one hundred thirty in our study (11.86%). There were three hundred fifty six diabetic patients (32.48%). Repeat procedure was done in ninety five patients (8.6%).

Results: Our study consisted of 1096 patients. Pacemaker pocket infection occurred in sixteen patients (1.5%). Chronic renal failure patients were one hundred thirty in our study (11.86%). There were three hundred fifty six diabetic patients (32.48%). Repeat procedure was done in ninety five patients (8.6%)

Eighty six patients were suffering from chronic obstructive airway (7.8%). Patients on immunosuppressive therapy were fourteen in our study (1.2%).

Conclusion: Pacemaker pocket infections is a dreaded complication after pacemaker implantation. During implantation, there is a risk of device contamination with the patient’s own skin flora and it can be prevented by ideal surgical asepsis technique, pre and perioperative use of antibiotics.

Read Full Article HTML DOI: 10.29328/journal.jccm.1001087 Cite this Article Read Full Article PDF

Keywords:

Cardiac pacemaker; Pacemaker pocket infection; Different risk factors

References

  1. Nery PB, Fernandes R, Nair GM, Sumner GL, Ribas CS, et al. Device-related infection among patients with pacemakers and implantable defibrillators: incidence, risk factors, and consequences. J Cardiovasc Electrophysiol. 2010: 21, 786- 90. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/20102431
  2. Cantillon DJ, Exner DV, Badie N, Davis K, Gu NY, et al. Complications and Health Care Costs Associated With Transvenous Cardiac Pacemakers in a Nationwide Assessment. JACC: Clinical Electrophysiology. 2017; 3: 1296-1305. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/29759627
  3. Poole JE, Gleva MJ, Mela T, Chung MK, Uslan DZ, et al. Complication rates associated with pacemaker or implantable cardioverter-defibrillator generator replacements and upgrade procedures: results from the REPLACE registry. Circulation. 2010; 122:1553-1561. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/20921437
  4. Margey R, McCann H, Blake G, Keelan E, Galvin J, et al .Contemporary management of and outcomes from cardiac device related infections. Europace. 2010; 12: 64 -70. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/19910314
  5. Sohail MR, Henrikson CA, Braid Forbes MJ, Forbes KF, Lerner DJ. Mortality and cost associated with cardiovascular implantable electronic device infections. Arch Intern Med. 2011; 171: 182-186. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/21911623
  6. Greenspon AJ, Patel JD, Lau E, Ochoa JA, Frisch DR, et al. 16-year trends in the infection burden for pacemakers and implantable cardioverter-defibrillators in the United States 1993 to 2008. J Am Coll Cardiol. 2011; 58: 1001-1006. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/21867833
  7. Lee I, Agarwal RK, Lee BY, Fishman NO, Umscheid CA. Systematic review and cost analysis comparing use of chlorhexidine with use of iodine for preoperative skin antisepsis to prevent surgical site infection. Infect Control Hosp Epidemiol. 2010; 31: 1219- 1229. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/20969449
  8. Bertaglia E, Zerbo F, Zardo S, Barzan D, Zoppo F, et al. Antibiotic prophylaxis with a single dose of cefazolin during pacemaker implantation: incidence of long-term infective complications. Pacing Clin Electrophysiol. 2006; 29: 29-33. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/16441714
  9. Lakkireddy D, Valasareddi S, Ryschon K, Basarkodu K, Rovang K, et al. The impact of povidone-iodine pocket irrigation use on pacemaker and defibrillator infections. Pacing Clin Electrophysiol. 2005; 28: 789- 794. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/16105006
  10. Athan E, Chu VH, Tattevin P, Selton-Suty C, Jones P, et al. Clinical characteristics and outcome of infective endocarditis involving implantable cardiac devices. JAMA. 2012; 307: 1727- 1735. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/22535857
  11. Darouiche R, Mosier M, Voigt J. Antibiotics and antiseptics to prevent infection in cardiac rhythm management device implantation surgery. Pacing and Clinical Electrophysiology. 2012; 35: 1348- 1360. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/22946683
  12. Konstantinos A, Polyzos Athanasios A, Konstantelias Matthew E. Falagas. Risk factors for cardiac implantable electronic device infection: a systematic review and meta-analysis. Europace. 2015; 17: 767–767. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/25926473

Similar Articles

Recently Viewed

Read More

Most Viewed

Read More

Help ?