scholarly journals 121. Cardiac Implantable Electronic Device-Related Infective Endocarditis (CIED-IE): Clinical Features and Outcomes of Patients with Definite IE Who Fulfill Both Major Duke Criteria

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S91-S91
Author(s):  
Siddhi Gupta ◽  
Thomas F Wierzba ◽  
James E Peacock ◽  
Larry M Baddour ◽  
Muhammad R Sohail ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Electronic Device ◽  
Late Onset ◽  
Symptom Duration ◽  
Implantable Cardioverter Defibrillators ◽  
Cardiac Implantable Electronic Device ◽  
Coagulase Negative Staphylococci ◽  
Risk Of Death ◽  
Duke Criteria ◽  
Device Infection

Abstract Background Cardiac implantable electronic device-related infective endocarditis (CIED-IE) comprises 10–57% of total CIED infections. Patients with definite CIED-IE who fulfill both major modified Duke criteria have not been well characterized. Methods Data from the Multicenter Electrophysiologic Device Infection Cohort, a prospective, multinational study of CIED infections were used to describe a subset of patients with CIED-IE who met both major Duke criteria for definite IE (bloodstream infection and intracardiac vegetations [VEG]). Results Of 433 patients with CIED infection, 144 (33.3%) had definite CIED-IE. The median age was 68 years and 77.1% were male. Twelve (8.3%) had past CIED infection. Seventy-seven patients (53.5%) had permanent pacemakers, 38 (26.4%) had implantable cardioverter defibrillators, and 29 (20.1%) had combination devices. The median time following the last device procedure was 550 days. CIED-IE was early in 60 patients (41.7%) and late in 84 (58.3%). Most patients presented with fever (77.8%) and sepsis (44.4%) with a median symptom duration of 7 days. On echocardiography, lead VEG was noted in 125 patients (86.8%) and valvular VEG in 54 patients (37.5%) with the tricuspid valve involved in 56.5%. On the basis of VEG location, there were 90 patients (62.5%) with isolated lead-associated IE (LAE), 19 patients (13.2%) with isolated valve-associated IE (VAE), and 35 patients (24.3%) with both (LVAE). All patients had positive blood cultures and 63/119 (52.9%) had positive lead cultures. The predominant organism in blood was Staphylococcus aureus (42.4%), followed by coagulase-negative staphylococci (20.1%). CIED removal occurred in 131 patients (91%). There were 25 deaths during the index hospitalization and 34 total deaths (24.3%) by 6 months. Mortality correlated with age >75 (P = 0.023) and sepsis on presentation (P = 0.052). Infecting organism, site of VEG, and device removal did not impact the risk of death. Conclusion Definite CIED-IE is relatively common. The majority of patients tend to have late-onset infection and often present with sepsis. S. aureus is the dominant organism causing definite CIED-IE. Isolated LAE occurs in 63% of patients. Older age and sepsis on admission are associated with higher mortality. Disclosures All authors: No reported disclosures.

scholarly journals Infective endocarditis and risk of death after cardiac implantable electronic device implantation: a nationwide cohort study

EP Europace ◽  
2017 ◽  
Vol 19 (6) ◽  
pp. 1007-1014 ◽  
Author(s):  
Cengiz Özcan ◽  
Jakob Raunsø ◽  
Morten Lamberts ◽  
Lars Køber ◽  
Tommi Bo Lindhardt ◽  
...  
Keyword(s):  
Cohort Study ◽  
Infective Endocarditis ◽  
Electronic Device ◽  
Cardiac Implantable Electronic Device ◽  
Risk Of Death ◽  
Device Implantation

scholarly journals Impact of Choice of Prophylaxis on the Microbiology of Cardiac Implantable Electronic Device Infections: Insights from the Prevention of Arrhythmia Device infection Trial (PADIT)

2021 ◽  
Author(s):  
Yves Longtin ◽  
Philippe Gervais ◽  
David H Birnie ◽  
Jia Wang ◽  
Marco Alings ◽  
...  
Keyword(s):  
Electronic Device ◽  
Risk Of Infection ◽  
Cardiac Implantable Electronic Device ◽  
Coagulase Negative Staphylococci ◽  
Exact Test ◽  
Post Hoc Analysis ◽  
Perioperative Prophylaxis ◽  
Device Infection ◽  
Significant Difference ◽  
Post Hoc

Abstract Background The Prevention of Arrhythmia Device Infection Trial (PADIT) investigated whether intensification of perioperative prophylaxis could prevent cardiac implantable electronic device (CIED) infections. Compared with a single dose of cefazolin, the peri-operative administration of cefazolin, vancomycin, bacitracin and cephalexin did not significantly decrease the risk of infection. Our objective is to compare the microbiology of infections between study arms in PADIT. Methods Post-hoc analysis. Differences between study arms in the microbiology of infections were assessed at the level of individual patients and at the level of microorganisms using the Fisher’s exact test. Results Overall, 209 microorganisms were reported from 177 patients. The most common microorganisms were coagulase-negative staphylococci (CoNS, 82/209; 39.2%) and S. aureus (75/209; 35.9%). There was a significantly lower proportion of CoNS in the incremental arm compared with the standard arm (30.1% vs. 46.6%, p=0.04). However, there was no significant difference between study arms in the frequency of recovery of other microorganisms. In terms of antimicrobial susceptibility, 26.5% of microorganisms were resistant to cefazolin. CoNS were more likely to be cefazolin-resistant in the incremental arm (52.2% vs. 26.8%, respectively; p=0.05). However, there was no difference between study arms in terms of infections in which the main pathogen was sensitive to cefazolin (77.8% vs. 64.3%; p=0.10) or vancomycin (90.8% vs. 90.2%; p=0.90). Conclusions Intensification of the prophylaxis led to significant changes in the microbiology of infections, despite the absence of a decrease in the overall risk of infections. These findings provide important insight on the physiopathology of CIED infections.

scholarly journals Postimplantation pocket hematoma increases risk of cardiac implantable electronic device infection: A meta‐analysis

2021 ◽  
Author(s):  
Jakrin Kewcharoen ◽  
Chanavuth Kanitsoraphan ◽  
Sittinun Thangjui ◽  
Thiratest Leesutipornchai ◽  
Sakditad Saowapa ◽  
...  
Keyword(s):  
Electronic Device ◽  
Meta Analysis ◽  
Cardiac Implantable Electronic Device ◽  
Device Infection ◽  
Pocket Hematoma

scholarly journals Brucella cardiac implantable electronic device infection: A single-center case series

2021 ◽  
pp. 102568
Author(s):  
Fatehi Elzein ◽  
Eid Alsufyani ◽  
Yahya Al Hebaishi ◽  
Mohammed Mosaad ◽  
Moayad Alqurashi ◽  
...  
Keyword(s):  
Electronic Device ◽  
Case Series ◽  
Single Center ◽  
Cardiac Implantable Electronic Device ◽  
Device Infection

scholarly journals Positive predictive value of infective endocarditis in the Danish National Patient Registry: a validation study

2018 ◽  
Vol 146 (15) ◽  
pp. 1965-1967 ◽  
Author(s):  
Lauge Østergaard ◽  
Kasper Adelborg ◽  
Jens Sundbøll ◽  
Lars Pedersen ◽  
Emil Loldrup Fosbøl ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Medical Records ◽  
Electronic Device ◽  
Patient Registry ◽  
Cardiac Implantable Electronic Device ◽  
National Patient Registry ◽  
Danish National Patient Registry ◽  
National Patient

AbstractThe positive predictive value of an infective endocarditis diagnosis is approximately 80% in the Danish National Patient Registry. However, since infective endocarditis is a heterogeneous disease implying long-term intravenous treatment, we hypothesiszed that the positive predictive value varies by length of hospital stay. A total of 100 patients with first-time infective endocarditis in the Danish National Patient Registry were identified from January 2010 – December 2012 at the University hospital of Aarhus and regional hospitals of Herning and Randers. Medical records were reviewed. We calculated the positive predictive value according to admission length, and separately for patients with a cardiac implantable electronic device and a prosthetic heart valve using the Wilson score method. Among the 92 medical records available for review, the majority of the patients had admission length ⩾2 weeks. The positive predictive value increased with length of admission. In patients with admission length <2 weeks the positive predictive value was 65% while it was 90% for admission length ⩾2 weeks. The positive predictive value was 81% for patients with a cardiac implantable electronic device and 87% for patients with a prosthetic valve. The positive predictive value of the infective endocarditis diagnosis in the Danish National Patient Registry is high for patients with admission length ⩾2 weeks. Using this algorithm, the Danish National Patient Registry provides a valid source for identifying infective endocarditis for research.

Abstract 12672: Post-Implantation Hematoma Increases Risk of Cardiac Implantable Electronic Device Infection: A Systematic Review and Meta-analysis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jakrin Kewcharoen ◽  
Chanavuth Kanitsoraphan ◽  
Sittinun Thangjui ◽  
Thiratest Leesutipornchai ◽  
Leenhapong Navaravong
Keyword(s):  
Systematic Review ◽  
Cohort Studies ◽  
Electronic Device ◽  
Meta Analysis ◽  
Case Control ◽  
Cardiac Implantable Electronic Device ◽  
Case Control Studies ◽  
Randomized Controlled ◽  
Device Infection ◽  
Post Implantation

Introduction: Several studies have shown inconsistent relationship between post-implantation hematoma (PH) and cardiac implantable electronic device (CIED) infection. In this study, we performed a systematic review and meta-analysis to explore the effect of PH and the risk of CIED infection. Hypothesis: PH increases the risk of CIED infection. Methods: We searched the databases of MEDLINE and EMBASE from inception to March 2020. Included studies were cohort studies, case-control studies, cross-sectional studies and randomized controlled trials that reported incidence of PH and CIED infection during the follow-up period. CIED infection was defined as either a device-related local or systemic infection. Data from each study were combined using the random-effects, generic inverse variance method of Der Simonian and Laird to calculate odds ratios (OR) and 95% confidence intervals (CI). Results: Fourteen studies from 2006 to 2018 were included, involving a total of 28,319 participants. There were 6 cohort studies, 7 case-control studies and 1 randomized controlled trial. In random-effect model, we found that PH significantly increases the risk of overall CIED infection (OR = 6.30, 95%CI: 3.87-10.24, I2=49.3%) (Figure 1). There was no publication bias observed in the funnel plot as well as no small-study effect observed in Egger’s test. Conclusions: Our meta-analysis demonstrated that PH significantly increases the risk of CIED infection. Precaution should be taken to during device implantation to reduce PH and subsequent CIED infection.

Cardiac implantable electronic device infection

2017 ◽  
Vol 84 (12 suppl 3) ◽  
pp. 47-53 ◽  
Author(s):  
Cameron T. Lambert ◽  
Khaldoun G. Tarakji
Keyword(s):  
Electronic Device ◽  
Cardiac Implantable Electronic Device ◽  
Device Infection
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