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Cardiac Pacemaker Infection

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1. The MicraTM Transcatheter Pacing System, a leadless pacemaker, in patients indicated for single-chamber ventricular pacemaker implantation

About NIPH Close The MicraTM Transcatheter Pacing System, a leadless pacemaker, in patients indicated for single-chamber ventricular pacemaker implantation: A single technology assessment Order Download: Summary Background Permanent cardiac pacing using pacemaker implantation is an effective and necessary treatment for patients suffering from atrial fibrillation and bradycardia. In this single technology assessment, we assessed a leadless pacemaker for patients indicated for single-chamber (...) . However, we did not perform a systematic search of studies comparing the two types of pacemaker devices in the specific sub-group analysed in this report. The effect estimates in the economic model are therefore highly uncertain which made it difficult to make any general judgements about the potential cost-effectiveness of the intervention. The exception is that the rates of lead and pocket infection and erosion for a conventional device are likely to have a significant impact on the results

2018 Norwegian Institute of Public Health

2. Cardiac rehabilitation for a skydiver after aortic valve replacement for pure aortic regurgitation and resection of the ascending aorta complicated by active infective endocarditis and heart block requiring a pacemaker (PubMed)

Cardiac rehabilitation for a skydiver after aortic valve replacement for pure aortic regurgitation and resection of the ascending aorta complicated by active infective endocarditis and heart block requiring a pacemaker A professional skydiver underwent aortic valve and ascending aorta replacement complicated by infective endocarditis with root abscess and pacemaker implantation. He then enrolled in the Baylor Heart and Vascular Hospital cardiac rehabilitation (CR) program as part of its (...) specificity of testing and exercise training facility. He performed specific skydiving cardiovascular and muscular strength tests at the beginning and the end of the CR program. His pacemaker was interrogated to ascertain any arrhythmias or lead displacement over the course of the CR program. Daily exercise training was customized to match the physical demands of skydiving, including two sessions at iFLY Dallas. Upon completion of the daily exercise sessions, the patient performed a simulated free-fall

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2017 Proceedings (Baylor University. Medical Center)

3. Leadless pacemaker implantation after explantation of infected conventional pacemaker systems: A viable solution? (PubMed)

Leadless pacemaker implantation after explantation of infected conventional pacemaker systems: A viable solution? Conventional cardiac device infections are increasing in incidence, causing significant morbidity and mortality. Leadless pacemaker (LP) therapy may provide new opportunities for the management of pacemaker (PM) infections as it does not require implantation of transvenous leads and a pectoral pocket.We sought to evaluate the effect of early and late LP implantation in patients (...) diagnosed with device infection.Patients receiving an LP at our center after conventional PM lead extraction due to infection between December 1, 2013 and November 30, 2017 were included.A total of 17 patients (mean age 77.4 ± 7.77 years) underwent LP implantation (ie, 11 with Nanostim leadless cardiac pacemaker [Abbott, Chicago, IL] and 6 with Micra transcatheter pacing system [Medtronic, Minneapolis, MN]) after successful PM system explantation. In 9 PM-dependent patients, a temporary transvenous

2018 Heart Rhythm

4. Septic Pulmonary Embolism Caused by Infected Pacemaker Leads After Replacement of a Cardiac Resynchronization Therapy Device (PubMed)

Septic Pulmonary Embolism Caused by Infected Pacemaker Leads After Replacement of a Cardiac Resynchronization Therapy Device BACKGROUND Cardiac resynchronization therapy (CRT) has been demonstrated to reduce morbidity and mortality in patients with advanced, drug-refractory heart failure. Procedure-related mortality is less than 1% in larger studies. Approximately10% of CRT patients have to undergo surgical revision because of infections, dislocations, or unacceptable electrical behavior (...) manifested as high threshold, unstable sensing, or unwanted phrenic nerve stimulation. CASE REPORT A 70-year-old man with symptomatic congestive heart failure underwent implantation of a biventricular pacemaker on the left anterior chest wall in 2003 and pulse generator exchange in August 2009. The patient responded well to CRT. At follow-up, the pacing system functioned normally. In September 2009, in the context of a predialysis program, an abdominal computed tomography (CT) scan was performed

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2016 The American journal of case reports

5. Implantation of a leadless cardiac pacemaker for recurrent pocket infections (PubMed)

Implantation of a leadless cardiac pacemaker for recurrent pocket infections 28491705 2019 02 26 2214-0271 2 4 2016 Jul HeartRhythm case reports HeartRhythm Case Rep Implantation of a leadless cardiac pacemaker for recurrent pocket infections. 339-341 10.1016/j.hrcr.2016.03.011 Chang Philip M PM Keck School of Medicine of University of Southern California (USC), Keck Medical Center of USC, Los Angeles, California. Doshi Rahul N RN Keck School of Medicine of University of Southern California (...) (USC), Keck Medical Center of USC, Los Angeles, California. eng Case Reports 2016 04 07 United States HeartRhythm Case Rep 101656239 2214-0271 Cardiovascular implantable electronic devices Infection 2017 5 12 6 0 2017 5 12 6 0 2017 5 12 6 1 epublish 28491705 10.1016/j.hrcr.2016.03.011 S2214-0271(16)30027-6 PMC5419888 Clin Microbiol Rev. 2006 Apr;19(2):403-34 16614255 Circulation. 2010 Jan 26;121(3):458-77 20048212 J Am Coll Cardiol. 2011 Aug 30;58(10):1001-6 21867833 N Engl J Med. 2015 Sep 17;373

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2016 HeartRhythm Case Reports

6. Cardiac Pacemaker Infection

Cardiac Pacemaker Infection Cardiac Pacemaker Infection Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Cardiac Pacemaker Infection (...) Cardiac Pacemaker Infection Aka: Cardiac Pacemaker Infection , Pacemaker Infection , Implanted Cardiac Defibrillator Infection From Related Chapters II. Epidemiology Device infections increased nearly 4 fold since 1990 as of 2006 Implants on older patients with comorbidities with more frequent revisions Nearly 31,000 device infections per year in United States Nearly two thirds are under-treated without device extraction, with a higher mortality and endocarditis risk (see below) Risk of infection

2018 FP Notebook

7. Primary Cardiac B-Non-Hodgkin Lymphoma Disguised as a Pacemaker Endocarditis (PubMed)

Primary Cardiac B-Non-Hodgkin Lymphoma Disguised as a Pacemaker Endocarditis Background  Pacemaker infections rates are high compared with the incidence of primary malignant cardiac tumors. However, they can look alike in diagnostics and patient presentation. Case Description  We hereby report a rare case of a suspected pacemaker endocarditis which in fact turned out to be a primary cardiac B cell lymphoma. The lymphoma was removed surgically. Conclusion  Sometimes we encounter the unexpected (...) . Suboptimal preoperative diagnostics certainly lead to the faulty conclusion of an endocarditis. Nonetheless, even such an enhanced primary cardiac tumor can be resected with good clinical outcome and long-term survival.

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2018 The Thoracic and Cardiovascular Surgeon Reports

8. The Composition and Structure of Biofilms Developed by Propionibacterium acnes Isolated from Cardiac Pacemaker Devices (PubMed)

The Composition and Structure of Biofilms Developed by Propionibacterium acnes Isolated from Cardiac Pacemaker Devices The present study aimed to understand the biofilm formation mechanism of Propionibacterium acnes by analyzing the components and structure of the biofilms. P. acnes strains were isolated from the surface of explanted cardiac pacemaker devices that exhibited no clinical signs of infection. Culture tests using a simple stamp culture method (pressing pacemakers against the surface (...) of agar plates) revealed frequent P. acnes colonization on the surface of cardiac pacemaker devices. P. acnes was isolated from 7/31 devices, and the isolates were categorized by multilocus sequence typing into five different sequence types (STs): ST4 (JK18.2), ST53 (JK17.1), ST69 (JK12.2 and JK13.1), ST124 (JK5.3), ST125 (JK6.2), and unknown ST (JK19.3). An in vitro biofilm formation assay using microtiter plates demonstrated that 5/7 isolates formed biofilms. Inhibitory effects of DNase I

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2018 Frontiers in microbiology

9. Intracolonic cardiac pacemaker: A case of device migration with colon perforation out of a subcutaneous epifascial pocket (PubMed)

Intracolonic cardiac pacemaker: A case of device migration with colon perforation out of a subcutaneous epifascial pocket 30479945 2019 02 26 2214-0271 4 11 2018 Nov HeartRhythm case reports HeartRhythm Case Rep Intracolonic cardiac pacemaker: A case of device migration with colon perforation out of a subcutaneous epifascial pocket. 497-500 10.1016/j.hrcr.2018.04.006 Russi Ian I Division of Cardiology, Heart Center Lucerne, Luzerner Kantonsspital, Lucerne, Switzerland. Liechti Rémy R Department (...) HeartRhythm Case Rep 101656239 2214-0271 CIED infection Colon perforation Device migration Endocarditis Heart block Lead extraction Pacemaker 2018 11 28 6 0 2018 11 28 6 0 2018 11 28 6 1 epublish 30479945 10.1016/j.hrcr.2018.04.006 S2214-0271(18)30065-4 PMC6241037 Circulation. 2010 Jan 26;121(3):458-77 20048212 Thorac Cardiovasc Surg. 1986 Oct;34(5):338-9 2431510 Ann Thorac Surg. 2007 Jun;83(6):2230-2 17532441 Circulation. 1998 May 12;97(18):1791-5 9603533 Heart Rhythm. 2014 Apr;11(4):595-601 24333543

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2018 HeartRhythm Case Reports

10. Biomarker-based diagnosis of pacemaker and implantable cardioverter defibrillator pocket infections: A prospective, multicentre, case-control evaluation. (PubMed)

Biomarker-based diagnosis of pacemaker and implantable cardioverter defibrillator pocket infections: A prospective, multicentre, case-control evaluation. The use of cardiac implantable electronic devices (CIED) has risen steadily, yet the rate of cardiac device infections (CDI) has disproportionately increased. Amongst all cardiac device infections, the pocket infection is the most challenging diagnosis. Therefore, we aimed to improve diagnosis of such pocket infection by identifying relevant (...) biomarkers.We enrolled 25 consecutive patients with invasively and microbiologically confirmed pocket infection. None of the patients had any confounding conditions. Pre-operative levels of 14 biomarkers were compared in infected and control (n = 50) patients. Our selected biomarkers included white blood cell count (WBC), C-reactive protein (CRP), procalcitonin (PCT), lipopolysaccharide binding protein, high-sensitivity C-reactive protein (HS-CRP), polymorphonuclear-elastase, presepsin, various interleukins

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2017 PLoS ONE

11. Is There Always a Need for Permanent Pacemaker Replacement After Device Infection? A Tale of Two Patients (PubMed)

Is There Always a Need for Permanent Pacemaker Replacement After Device Infection? A Tale of Two Patients There has been an increase in number of cardiac implantable electronic devices (CIEDs) implantation and with this we have witnessed increased rates of CIED infection mainly in elderly population. It is important to assess conditions that may not reliably improve with cardiac pacing or those who lack adequate beneficial effect from permanent pacing before contemplating implantation (...) or reimplantation of these devices. Sometimes, the initial cardiac pathology may revert obviating the need for reimplantation as in the two cases that we have discussed below. This reduces the chance of further infection of CIED, and decreases mortality and morbidity due to recurrent CIED infection and decreases cost of care.

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2018 Cardiology Research

12. Mid-axillary pacemaker re-implantation after contralateral pocket infection in an emaciated elderly case (PubMed)

Mid-axillary pacemaker re-implantation after contralateral pocket infection in an emaciated elderly case The number of implantations of cardiac implantable electrophysiological devices (CIEDs) has increased over the past several years. However, the aging population and expansion of indications for CIEDs have led to an increase in associated infections. We experienced a case of a 99-year-old man presenting with skin erosion at the pocket site, where a 6-month-old implantable pacemaker (...) was replaced. He was referred for pacemaker pocket infection and presented with fever accompanied by pain and swelling around pacemaker generator. We could not explant 7-year-old pacemaker leads and the patient refused to undergo either laser lead extraction or surgical removal. We planned to re-implant in the contralateral chest. However, the patient was emaciated with low body-mass-index (15.2 kg/m2), thus concerns arose about the possibility of tissue disruption and re-infection owing to thin skin

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2018 Journal of cardiology cases

13. The Diagnosis and Treatment of Pacemaker-Associated Infection. (PubMed)

The Diagnosis and Treatment of Pacemaker-Associated Infection. Approximately 105 000 cardiac electronic devices are newly implanted in Germany each year. Germany has the highest implantation rate with respect to population of any European country. Infections in cardiac implants are serious complications, with an associated in-hospital mortality of 5-15%. It is thus very important to optimize the diagnostic and therapeutic strategies by which such infections can be detected early and treated (...) generator is implanted or the intravascular portion of the electrodes. The most important elements of the diagnostic evaluation are: assessment of the local findings; pathogen identification by culture of peripheral blood, swabs of the infected site, or material recovered at surgery; and transesophageal echocardiography to detect endocarditic deposits on the electrodes or cardiac valves. The treatment consists of appropriate antibiotic administration and the complete removal of all foreign material

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2018 Deutsches Arzteblatt international

14. Intracardiac Abscess and Pacemaker Lead Infection Secondary to Hematogenous Dissemination of Methicillin-Sensitive Staphylococcus Aureus from a Prior Diabetic Foot Ulcer and Osteomyelitis (PubMed)

Intracardiac Abscess and Pacemaker Lead Infection Secondary to Hematogenous Dissemination of Methicillin-Sensitive Staphylococcus Aureus from a Prior Diabetic Foot Ulcer and Osteomyelitis BACKGROUND Intracardiac abscesses are an unusual occurrence in developed countries. With the increase in use of implantable cardiac devices, the increase use of and advancements in antibiotics, and the longevity of patients with cardiac devices, one may expect an increase in such infections; however, case (...) reports are rare. We are presenting a case in which hematogenous dissemination of methicillin-sensitive Staphylococcus aureus (MSSA) infection from a lower extremity diabetic ulcer propagated into an infected pacemaker lead and ultimately an intracardiac abscess of the right atrium. CASE REPORT A 77-year-old male with a history of MSSA diabetic foot infection complicated by osteomyelitis presented with fever, syncope, and wide complex tachycardia, and he was found to have an intracardiac abscess

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2018 The American journal of case reports

15. In vivo biocompatibility and pacing function study of silver ion-based antimicrobial surface technology applied to cardiac pacemakers (PubMed)

In vivo biocompatibility and pacing function study of silver ion-based antimicrobial surface technology applied to cardiac pacemakers Evidence suggests that the rate of cardiovascular implantable electronic device (CIED) infections is increasing more rapidly than the rates of CIED implantation and is associated with considerable mortality, morbidity and health economic impact. Antimicrobial surface treatments are being developed for CIEDs to reduce the risk of postimplantation infection within (...) the subcutaneous implant pocket.The feasibility of processing cardiac pacemakers with the Agluna antimicrobial silver ion surface technology and in vivo biocompatibility were evaluated. Antimicrobially processed (n=6) and control pacemakers (n=6) were implanted into subcutaneous pockets and connected to a part of the sacrospinalis muscle using an ovine model for 12 weeks. Pacemaker function was monitored preimplantation and postimplantation.Neither local infection nor systemic toxicity were detected

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2017 Open heart

16. Reuse of pacemakers, defibrillators and cardiac resynchronisation devices (PubMed)

Reuse of pacemakers, defibrillators and cardiac resynchronisation devices Access to pacemakers remains poor among many patients in low/middle-income countries. Reuse of explanted pacemakers is a possible solution, but is still not widespread because of concerns regarding outcomes, especially infection. Our objective was to study early outcomes with implants using reused devices and compare them with those with implants using new devices.We studied all patients who underwent implantation (...) of a new or reused pacemaker, cardiac resynchronisation therapy (CRT) device or implantable cardioverter defibrillator (ICD) in the last 5 years at a single institution. We analysed outcomes related to infection, device malfunction and device-related death within 6 months after initial implantation.During the study period, 887 patients underwent device implant, including 127 CRT devices or ICDs. Of these, 260 devices (29.3%) were reused and the others were new. At 6 months, there were three device

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2017 Heart Asia

17. Is there a correlation between late re-exploration after cardiac surgery and removal of epicardial pacemaker wires? (PubMed)

Is there a correlation between late re-exploration after cardiac surgery and removal of epicardial pacemaker wires? Re-exploration for bleeding accounts for increased morbidity and mortality after major cardiac operations. The use of temporary epicardial pacemaker wires is a common procedure at many departments. The removal of these wires postoperatively can potentially lead to a serious bleeding necessitating intervention.From Jan 2011 till Dec 2015 a total of 4244 major cardiac procedures (...) were carried out at our department. We used temporary epicardial pacemaker wires in all cases. We collected all re-explorations for bleeding and pericardial tamponade from our surgical database and then we focused on the late re-explorations, meaning on the 4th postoperative day and thereafter, trying to identify the removal of the temporary pacemaker wires as the definite cause of bleeding. Patients' records and medication were examined.Thirty-nine late re-explorations for bleeding, consisting

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2017 Journal of cardiothoracic surgery

18. A singular role of IK1 promoting the development of cardiac automaticity during cardiomyocyte differentiation by IK1–induced activation of pacemaker current (PubMed)

A singular role of IK1 promoting the development of cardiac automaticity during cardiomyocyte differentiation by IK1–induced activation of pacemaker current The inward rectifier potassium current (IK1) is generally thought to suppress cardiac automaticity by hyperpolarizing membrane potential (MP). We recently observed that IK1 could promote the spontaneously-firing automaticity induced by upregulation of pacemaker funny current (If) in adult ventricular cardiomyocytes (CMs). However (...) was also promoted in quiescent hESC-CMs by an IK1-specific agonist zacopride. In addition, we found that the number of spontaneously-firing m/hESC-CMs was significantly decreased when If was acutely upregulated by Ad-CGI-HCN infection. Our study reveals a novel role of IK1 promoting the development of cardiac automaticity in m/hESC-CMs through a mechanism of IK1-induced If activation and demonstrates a synergistic interaction between IK1 and If that regulates cardiac automaticity.

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2017 Stem Cell Reviews

19. Intrapocket Antibiotics to Prevent Infections from Implantable Cardioverter- Defibrillator and Pacemaker for Adult Patients Undergoing Device Insertion: A Review of Clinical Evidence and Comparative Clinical Effectiveness

. Circulation. 2007 Sep 18;116(12):1349-55. PubMed: PM17724263 5. Sohail MR, Uslan DZ, Khan AH, Friedman PA, Hayes DL, Wilson WR, et al. Risk factor analysis of permanent pacemaker infection. Clin Infect Dis. 2007 Jul 15;45(2):166-73. PubMed: PM17578774 Review Articles 6. Margey R. Cardiac implantable electronic device infections: the enemy that lurks beneath the skin. J Long Term Eff Med Implants. 2010;20(3):203-17. PubMed: PM21395519 7. Borek PP, Wilkoff BL. Pacemaker and ICD leads: strategies for long (...) Intrapocket Antibiotics to Prevent Infections from Implantable Cardioverter- Defibrillator and Pacemaker for Adult Patients Undergoing Device Insertion: A Review of Clinical Evidence and Comparative Clinical Effectiveness Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list

2012 Canadian Agency for Drugs and Technologies in Health - Rapid Review

20. Effect of pocket irrigation with antimicrobial on prevention of pacemaker pocket infection: a meta-analysis. (PubMed)

Effect of pocket irrigation with antimicrobial on prevention of pacemaker pocket infection: a meta-analysis. The presence of cardiac implantable electronic devices (CIEDs) pocket infection is difficult to treat, causing serious clinical outcomes, but little is known for prevention. Results from some studies suggested that pocket irrigation could reduce infection while others showed conflicting results. We pooled the effects of pocket irrigations on the prevention of pocket infection by meta (...) performed.We identified 10 studies providing data of 5467 patients receiving CIEDs implantations. Pooled infection rates were 1.48 and 3.49% respectively for medication and saline irrigation groups. Meta-analysis showed that medication irrigation conferred protection to pocket infection (RR = 0.44, 95% CI: 0.31-0.63). Subgroup analysis showed that antibiotics, rather than non-antibiotics (antiseptics) exerting the protection. The first and second lines antibiotics against staphylococcus aureus, which

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2017 BMC cardiovascular disorders

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