Spanish Heart Rhythm Association member´s perspectives on implantable cardiac device reuse in developing countries.

a) Introduction and objectives Postmortem explanted cardiac implantable electronic devices (CIEDs) from developed countries could provide patients unable to afford new devices in developing countries a treatment they lack nowadays. This study describes the preferences of cardiac electrostimulation specialists from Spain on the management of explanted CIEDs and opinions and concerns regarding reuse in developing countries. b) Methods A nationwide self-administered questionnaire was sent to Spanish members of the XXXX1 (n=1110), between December 2020 and January 2021. c) Results Forty-three responses were obtained (response rate 4%). There was a strong preference to donate explanted devices for reuse in humans (61.9%). The group of age younger than average was more against storing explanted CIEDs (p= 0.014). 57.1% considered it would be beneficial for patients to have a document so they could reflect their wishes regarding device handling after their death. 88.1% indicated that they would strongly agree or to implant postmortem resterilized pacemakers or ICDs (Implantable cardioverter defibrillator) containing >70% of the original battery life in patients who were unable to obtain a new one, the older than average age group was showed more agreement with this statement (p=0.02). The most mentioned concerns were device malfunction (57.1%) and infection (54.8%). d) Conclusions The majority of respondents support reusable CIEDs donation to developing countries. It would be interesting to study the feasibility of a nationwide CIED reutilization programme.

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Consensus document on radiotherapy in patients with implantable pacemakers and cardioverter – defibrilators

In a good rythm ◽

10.5604/01.3001.0012.0395 ◽

2018 ◽

Vol 2 (47) ◽

pp. 27-31

Author(s):

Lidia Chmielewska-Michalak ◽

Ewelina Konstanty ◽

Przemysław Mitkowski

Keyword(s):

Current Knowledge ◽

Clinical Status ◽

Electronic Devices ◽

Heart Rhythm ◽

Complex Care ◽

Consensus Document ◽

Cardiac Implantable Electronic Devices ◽

Number Of Patients ◽

High Level ◽

Emergency Mode

The number of patients with cardiac implantable electronic devices (CIED), who require oncological management including radiotherapy (RT) is still increasing. According to current knowledge the most frequent device dysfunction related to exposition to ionizing radiation is reprogramming to emergency mode (soft reset). There are uncommon cases of complete, irreversible device damage. CIED dysfunction during RT can be observed in approximately 3% of patients. In majority of cases they are asymptomatic, although in literature there are descriptions of deterioration of clinical status due to bradycardia or exacerbation of heart failure. The most important factor of device malfunction is radiotherapy with photons of energy >10 MV or protons despite energy used. So far there were no cases published with inadequate ICD therapies due to the presence of electromagnetic field interference during RT. Because patients with CIED undergoing RT need complex care to achieve high level of safety, experts of Heart Rhythm Society establish document, published in 2017 which summarized current knowledge about this group of patients. The document contains guidelines on peri-radiotherapy care of patients with CIED.

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Lead-Related Infective Endocarditis in Latvia: A Single Centre Experience

Medicina ◽

10.3390/medicina55090566 ◽

2019 ◽

Vol 55 (9) ◽

pp. 566

Author(s):

Nesterovics ◽

Stradins ◽

Kalejs ◽

Ansabergs ◽

...

Keyword(s):

Infective Endocarditis ◽

Electronic Devices ◽

Positive Culture ◽

Major Complication ◽

Heart Rhythm ◽

University Hospital ◽

Lead Extraction ◽

Coagulase Negative Staphylococci ◽

Cardiac Implantable Electronic Devices ◽

Common Location

Background and Objectives: Over the last five decades cardiac implantable electronic devices (CIED) have become established as the mainstay for the treatment of permanent bradycardias, chronic heart failure and dangerous heart rhythm disturbances. These devices improve survival and quality of life in many patients. However, infections associated with CIED implantation, particularly lead-related infective endocarditis (LRIE), can offset all benefits and make more harm than good for the patient. To date, there are no other studies in Latvia, addressing patients with lead-related infective endocarditis. The objective of this study was to identify the most common pathogens associated with LRIE and their antimicrobial resistance and to identify possible risk factors of patients who present with LRIE. Materials and Methods: The study was performed retrospectively at Pauls Stradins Clinical University Hospital (PSCUH). The study included patients who were referred to PSCUH due to LRIE for lead extraction. Patients were identified from procedural journals. Information about isolated microorganisms, patient comorbidities and visual diagnostics data was taken from patient records. Results: Forty-nine patients with CIED related infective endocarditis were included in the study, 34 (69.4%) were male, median age of all patients was 65.0 (50.5–73.0) years, median hospital stay was 15.5 (22.0–30.5) days. Successful and complete lead extraction was achieved in all patients. Thirty-two (65.3%) had received antibiotics prior to blood sample. Only in 31 (63.3%) positive culture results were seen. The most common isolated pathogens were Staphylococcus aureus (23.5%) and coagulase negative staphylococci (23.5%). Other bacteria were isolated considerably less often. The atrial lead was most common location for lead vegetations, seen in 50.0% of cases. Five (10.2%) patients have died due to the disease. Conclusions: Lead-related infective endocarditis is a major complication of cardiac implantable electronic devices with considerable morbidity and mortality, which in our study was as high as 10.2%.

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Remote monitoring of cardiac implantable electronic devices in Europe: results of the European Heart Rhythm Association survey

EP Europace ◽

10.1093/europace/eut414 ◽

2013 ◽

Vol 16 (1) ◽

pp. 129-132 ◽

Cited By ~ 30

Author(s):

A. Hernandez-Madrid ◽

T. Lewalter ◽

A. Proclemer ◽

L. Pison ◽

G. Y. H. Lip ◽

...

Keyword(s):

Remote Monitoring ◽

Electronic Devices ◽

Heart Rhythm ◽

Cardiac Implantable Electronic Devices

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Effectiveness And Adherence To Hospital Infection Control Preventive Practice In Cardiac Implantable Electronic Devices

QJM ◽

10.1093/qjmed/hcab090.017 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Michel Lotfy Kolta ◽

Maha Mohamed Mohamed Khalifa ◽

Mazen Tawfik Ibrahmi ◽

Said AbdElHaffez khaled

Keyword(s):

Diabetes Mellitus ◽

Infection Control ◽

Electronic Devices ◽

P Value ◽

Related Factors ◽

Cardiac Device ◽

Control Protocol ◽

The Past ◽

Cardiac Implantable Electronic Devices ◽

Device Implantation

Abstract Background Cardiac implantable electronic device (CIED) have been increasingly used in the past years, There is arise in CIED related complications in the past years with the increase in the number of devices implanted, CIED associated infection is challenging in its management, including system removal (generator and leads ), antimicrobial therapy, replantation at another site. Objectives The aim of the study is to evaluate the adherence to the steps of infection control protocol in cardiac device implantation related infection . Patients and Methods One hundred patients referred for cardiac device implantation was enrolled in the study and prospectively evaluated regarding applying of infection control measures and followed up for six months to study effect of adherence to these measures in prevention of postoperative device related infection. Results analysis of all factors of infection control protocol revealed significant correlation between postoperative device related infection and the following factors, Age ( p value = 0.010) , DM ( p value = 0.024) and number of Operators≥4.0 ( p = 0.001) as well as duration of sterilization ( p = 0.001), wearing double gloves (p = <0.001). Conclusion Our results proved certain factors as significant risk factors for device related infection, they are either patient related factors including and diabetes mellitus or device related factors reflecting higher incidence with CRT devices (p = 0.025), others related to applying anti septic measures namely double glove technique and duration of skin disinfect prior to the procedure. Abbreviation list; CIED (cardiac implantable electronic devices), DRI (device related infection), CKD (chronic kidney disease), DM (diabetes mellitus), HTN (hypertension), CRT (cardiac resynchronization therapy), DDD (dual chamber device), VVI (ventricular demand pacing), ICD (implantable cardioverter defibrillator).

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Access to and clinical use of cardiac implantable electronic devices and interventional electrophysiological procedures in the European Society of Cardiology Countries: 2016 Report from the European Heart Rhythm Association

EP Europace ◽

10.1093/europace/euw244 ◽

2016 ◽

Vol 18 (suppl 3) ◽

pp. iii1-iii79 ◽

Cited By ~ 36

Author(s):

M.J. Pekka Raatikainen ◽

David O. Arnar ◽

Bela Merkely ◽

A. John Camm ◽

Gerhard Hindricks

Keyword(s):

European Society ◽

Electronic Devices ◽

Heart Rhythm ◽

Clinical Use ◽

Cardiac Implantable Electronic Devices ◽

Electrophysiological Procedures ◽

European Society Of Cardiology

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Approach to cardio-oncologic patients with special focus on patients with cardiac implantable electronic devices planned for radiotherapy: results of the European Heart Rhythm Association survey

EP Europace ◽

10.1093/europace/eux195 ◽

2017 ◽

Vol 19 (9) ◽

pp. 1579-1584 ◽

Cited By ~ 9

Author(s):

Radosław Lenarczyk ◽

Tatjana S. Potpara ◽

Kristina H. Haugaa ◽

Jean-Claude Deharo ◽

Antonio Hernandez-Madrid ◽

...

Keyword(s):

Electronic Devices ◽

Heart Rhythm ◽

Special Focus ◽

Cardiac Implantable Electronic Devices ◽

Oncologic Patients

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Canadian Heart Rhythm Society and Canadian Association of Radiologists Consensus Statement on Magnetic Resonance Imaging with Cardiac Implantable Electronic Devices

Canadian Association of Radiologists Journal ◽

10.1016/j.carj.2014.08.001 ◽

2014 ◽

Vol 65 (4) ◽

pp. 290-300 ◽

Cited By ~ 11

Author(s):

Atul Verma ◽

Andrew C.T. Ha ◽

Carole Dennie ◽

Vidal Essebag ◽

Derek V. Exner ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Electronic Devices ◽

Heart Rhythm ◽

Resonance Imaging ◽

Cardiac Implantable Electronic Devices ◽

Canadian Association ◽

Mri Environment ◽

Magnetic Resonance Imaging Mri ◽

Mri Conditional

Magnetic resonance imaging (MRI) has historically been considered contraindicated for individuals with cardiac implantable electronic devices (CIEDs) such as pacemakers and implantable defibrillators. Magnetic resonance scanners produce magnetic fields that can interact negatively with the metallic components of CIEDs. However, as CIED technology has advanced, newer MRI conditional devices have been developed that are now in clinical use and these systems have had demonstrated safety in the MRI environment. Despite the supportive data of such CIED systems, physicians remain reluctant to perform MRI scanning of conditional devices. This joint statement by the Canadian Heart Rhythm Society and the Canadian Association of Radiologists describes a collaborative process by which CIED specialists and clinics can work with radiology departments and specialists to safely perform MRI in patients with MRI conditional CIED systems. The steps required for patient and scanning preparation and the roles and responsibilities of the CIED and radiology departments are outlined. We also briefly outline the risks and a process by which patients with nonconditional CIEDs might also receive MRI in highly specialized centres. This document supports MRI in patients with MRI conditional CIEDs and offers recommendations on how this can be implemented safely and effectively.

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Providing Patients with Implantable Cardiac Device Data through a Personal Health Record: A Qualitative Study

Applied Clinical Informatics ◽

10.4338/aci-2017-06-ra-0090 ◽

2017 ◽

Vol 08 (04) ◽

pp. 1106-1116 ◽

Cited By ~ 10

Author(s):

Carly Daley ◽

Elizabeth Chen ◽

Amelia Roebuck ◽

Romisa Ghahari ◽

Areej Sami ◽

...

Keyword(s):

Remote Monitoring ◽

Personal Health Record ◽

Heart Rhythm ◽

Personal Health ◽

Health Record ◽

Cardiac Device ◽

Cardiology Clinic ◽

Patients At Risk ◽

Life Threatening ◽

Implantable Cardiac Device

Background Patients at risk for sudden cardiac death or having suffered cardiac arrest may receive an implantable cardioverter defibrillator (ICD). This device provides monitoring and therapy for life-threatening heart rhythms. Remote monitoring of ICDs has decreased the time between abnormal heart rhythm events and clinic follow-up. Currently, the data transmitted from the device are reviewed and stored by the clinic, but patients do not have access to the data. While connecting patients directly with their ICD data has potential to enhance engagement in their care and improve health outcomes, patient attitudes and perceptions about receiving ICD data have not been explored. Objective This research is the first demonstration of delivering ICD data to patients through a personal health record (PHR) using a novel technical framework. The objective of this study was to use a PHR interface as a technology probe to explore patients' experiences with directly receiving their ICD data from remote monitoring. Methods We enrolled 21 patients with an ICD undergoing remote monitoring at a large outpatient cardiology clinic in Indiana, United States. Participants received their ICD data from remote monitoring through a PHR over 3 months. In-depth, semistructured interviews were conducted at 3 months and analyzed using thematic analysis. Results Participants were 36 to 86 years old, mean age (SD) of 67 (14) years, predominately male (76%), and white (95%). Key themes were ICD questions and concerns, experiences with remote monitoring, PHR use, and feedback about the ICD data summary. The findings showed that overall, patients desired information that provides reassurance, is easy to understand, and is presented in a meaningful way. Conclusion Sharing ICD data from remote monitoring requires adequate context and scaffolding to support patient understanding. Engaging patients with information that is useful and valuable to them through a PHR may require appropriate and individualized tailoring of information.

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