Local complications in patients with cardiac implantable devices

2019 ◽  
Vol 1 (50) ◽  
pp. 14-18
Author(s):  
Karolina Adamczyk ◽  
Ewa Jędrzejczyk-Patej
Keyword(s):  
Electronic Devices ◽  
Implantable Devices ◽  
Cardiac Resynchronization ◽  
Implantable Cardioverter Defibrillators ◽  
Systemic Complications ◽  
Local Complications ◽  
Cardiac Implantable Electronic Devices ◽  
Cardioverter Defibrillators ◽  
Life Prolongation ◽  
Pocket Hematoma

Cardiac implantable electronic devices (CIEDs) such as pacemakers (PMs), implantable cardioverter-defibrillators (ICDs), both with or without cardiac resynchronization therapy (CRT), became one of the fundamental therapies in present-day electrocardiology. The CIED patients population is increasing year by year due to a growing number of CIED implantations annually and a life prolongation among patients with CIEDs through better pharmacology combined with the proper electrotherapy and patient care. Invasive procedures related to CIED such as an implantation, a replacement or an up-grade of any kind electrotherapy device involves the risk of complications. Pocket hematoma or infection, which are local complications, should be recognized rapidly and treat properly in order to avoid more threatening systemic complications.

Considerations in Patients With Cardiac Implantable Electronic Devices at End of Life

2015 ◽  
Vol 26 (4) ◽  
pp. 356-363
Author(s):  
Melanie T. Gura
Keyword(s):  
Terminal Illness ◽  
Electronic Devices ◽  
Cardiac Resynchronization ◽  
Implantable Cardioverter Defibrillators ◽  
Resynchronization Therapy ◽  
Cardiac Pacemakers ◽  
Cardiac Implantable Electronic Devices ◽  
Life Saving ◽  
Cardioverter Defibrillators ◽  
Proactive Communication

Since the introduction of implantable cardiac pacemakers in 1958 and implantable cardioverter-defibrillators in 1980, these devices have been proven to save and prolong lives. Pacemakers, implantable cardioverter-defibrillators, and cardiac resynchronization therapy are deemed life-sustaining therapies. Despite these life-saving technologies, all patients ultimately will reach the end of their lives from either their heart disease or development of a terminal illness. Clinicians may be faced with patient and family requests to withdraw these life-sustaining therapies. The purpose of this article is to educate clinicians about the legal and ethical principles that underlie withdrawal of life-sustaining therapies such as device deactivation and to highlight the importance of proactive communication with patients and families in these situations.

scholarly journals The New Challenge for Heart Endocarditis: From Conventional Prosthesis to New Devices and Platforms for the Treatment of Structural Heart Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-17
Author(s):  
Francesco Nappi ◽  
Adelaide Iervolino ◽  
Sanjeet Singh Avtaar Singh
Keyword(s):  
Inflammatory Responses ◽  
Clinical Success ◽  
Electronic Devices ◽  
Structural Heart Disease ◽  
Cardiac Resynchronization ◽  
Implantable Cardioverter Defibrillators ◽  
Noticeable Increase ◽  
Cardiac Implantable Electronic Devices ◽  
Cardiac Resynchronization Therapy Devices ◽  
Transcatheter Heart Valve

Infective endocarditis is a sinister condition with considerable morbidity and mortality. Its relevance in the current era is compounded by the increased use of implanted devices such as replacement valves or cardiac implantable electronic devices. These infections are caused by multiple different bacteria with different virulence, pathogenicity, and antimicrobial resistance. Unlike in native endocarditis, the presence of foreign tissue permits sustenance by inflammatory and thrombotic processes as the artificial surfaces promote inflammatory responses and hypercoagulability. Prevention of these infections has been suggested with the use of homografts in combination with antibiotics. Others have attempted to use “low fouling coats” with little clinical success thus far. The use of antibiotic prophylaxis plays a pivotal part in reducing the incidence of prosthesis-related endocarditis. This remains especially crucial with the increasing use of transcatheter heart valve therapies. The widespread use of cardiac implantable electronic devices such as permanent pacemakers, implantable cardioverter defibrillators, and cardiac resynchronization therapy devices has also heralded a noticeable increase in cases of infectious endocarditis affecting complex equipment which can be difficult to treat. Multimodality strategies are needed with input from surgeons and cardiologists to ensure treatment is both prompt and successful, tailored to the individual needs of the patients.

Home Monitoring for Cardiovascular Implantable Electronic Devices

2015 ◽  
Vol 26 (4) ◽  
pp. 343-355 ◽  
Author(s):  
Robin A. Leahy ◽  
Elizabeth E. Davenport
Keyword(s):  
Electronic Devices ◽  
Home Monitoring ◽  
Cardiac Resynchronization ◽  
Implantable Cardioverter Defibrillators ◽  
Resynchronization Therapy ◽  
Cardiovascular Implantable Electronic Devices ◽  
Technological Advances ◽  
Cardiac Resynchronization Therapy Devices ◽  
Cardioverter Defibrillators

Recent technological advances in the management of patients with cardiovascular implantable electronic devices (CIEDs) have expanded clinicians’ ability to remotely monitor patients with CIEDs. Remote monitoring, in addition to periodic in-person device evaluation, provides many advantages to patients and clinicians. Aside from the therapeutic and diagnostic benefits of pacemakers, implantable cardioverter-defibrillators, cardiac resynchronization therapy devices, and implantable loop recorders, improvement in clinical outcomes, clinical efficiencies, and patient experience can be realized with the adoption of remote CIED monitoring. These advantages create significant value to both patients and CIED follow-up centers.

Late Breaking Clinical Trials: what do they change in everyday practice in patients who are or will be implanted with cardiac electrotherapy device?

2020 ◽  
Vol 4 (53) ◽  
pp. 4-7
Author(s):  
Ewa Jędrzejczyk-Patej ◽  
Michał Mazurek
Keyword(s):  
Clinical Trials ◽  
Electronic Devices ◽  
Everyday Practice ◽  
Cardiac Resynchronization ◽  
Cardiac Pacemakers ◽  
Cardiac Implantable Electronic Devices ◽  
Cardioverter Defibrillators

Patients with cardiac implantable electronic devices (CIEDs) constitute a considerable population. Issues related to CIEDs both in the field of cardiac pacemakers, cardioverter-defibrillators, and cardiac resynchronization are still intensively studied. This article presents the results of selected, relevant studies on CIEDs announced or published in 2019.

scholarly journals JASTRO/JCS Guidelines for radiotherapy in patients with cardiac implantable electronic devices

2020 ◽  
Vol 62 (1) ◽  
pp. 172-184
Author(s):  
Toshiki Ohno ◽  
Toshinori Soejima ◽  
Yukio Sekiguchi ◽  
Takayuki Hashimoto ◽  
Izumi Koike ◽  
...  
Keyword(s):  
Japanese Society ◽  
Electronic Devices ◽  
Implantable Cardioverter Defibrillators ◽  
Implantable Defibrillators ◽  
English Version ◽  
Cardiac Implantable Electronic Devices ◽  
New Findings ◽  
Multidisciplinary Working ◽  
Medical Physicists ◽  
Cardioverter Defibrillators

ABSTRACT This publication is an English version of the Japanese Society for Radiation Oncology (JASTRO) and The Japanese Circulation Society official guidelines for patients with cardiac implantable electronic devices (CIEDs). Several radiotherapy-associated malfunctions have been reported for CIEDs such as pacemakers and implantable cardioverter-defibrillators. Accordingly, guidelines for radiotherapy in patients with CIEDs have been issued by other countries and societies. In August 2010, JASTRO published the ‘Radiotherapy Guidelines for Patients with Pacemakers and Implantable Defibrillators’ (hereafter referred to as the former guidelines). Given new findings in this decade, a multidisciplinary working group of radiation oncologists, medical physicists, radiation therapists and cardiologists jointly reviewed and revised the former guidelines.

scholarly journals Practice Advisory for the Perioperative Management of Patients with Cardiac Implantable Electronic Devices: Pacemakers and Implantable Cardioverter–Defibrillators 2020

2020 ◽  
Vol 132 (2) ◽  
pp. 225-252 ◽  
Keyword(s):  
Healthcare Professionals ◽  
Perioperative Management ◽  
Task Force ◽  
Electronic Devices ◽  
Implantable Cardioverter Defibrillators ◽  
Cardiac Implantable Electronic Devices ◽  
Practice Advisory ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Cardioverter Defibrillators

This practice advisory updates the “Practice Advisory for the Perioperative Management of Patients with Cardiac Implantable Electronic Devices: Pacemakers and Implantable Cardioverter–Defibrillators: An Updated Report by the American Society of Anesthesiologists Task Force on Perioperative Management of Patients with Cardiac Implantable Electronic Devices,” adopted by the American Society of Anesthesiologists in 2010 and published in 2011. This updated advisory is intended for use by anesthesiologists and all other individuals who deliver or who are responsible for anesthesia care. The update may also serve as a resource for other physicians and healthcare professionals who manage patients with cardiac implantable electronic devices. Supplemental Digital Content is available in the text.

Anesthetic Management of Laser Lead Extraction for Cardiovascular Implantable Electronic Devices

2017 ◽  
Vol 21 (4) ◽  
pp. 302-311 ◽  
Author(s):  
Meena Bhatia ◽  
Payam Safavi-Naeini ◽  
Mehdi Razavi ◽  
Charles D. Collard ◽  
Daniel A. Tolpin ◽  
...  
Keyword(s):  
Anesthetic Management ◽  
Electronic Devices ◽  
Cardiac Resynchronization ◽  
Lead Extraction ◽  
Lead Removal ◽  
Implantable Cardioverter Defibrillators ◽  
Cardiovascular Implantable Electronic Devices ◽  
Number Of Patients ◽  
Cardioverter Defibrillators

Cardiovascular implantable electronic devices (CIEDs) play a significant role in the modern management of cardiovascular disease. CIEDs include implantable pacemakers (PMs), implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices. These devices improve the quality of life of their recipients and help reduce the incidence of sudden cardiac death. Traditionally, CIEDs have been reliant on the use of transvenous endocardial leads to directly connect with the heart. Over time, these endovascular leads may become endothelialized rendering removal extremely difficult. As the indications for CIEDs expands and with the continuing evolution of these devices, the number of patients requiring explantation for device recall, malfunction, and infection continues to increase. In this manuscript, we review the most common CIEDs, the indications and process of lead removal/device explantation, potential complications associated with the procedure and the anesthetic management of these patients.

Cardiac Implantable Electronic Device Implantation

2015 ◽  
Vol 26 (4) ◽  
pp. 312-319 ◽  
Author(s):  
Melissa E. Harding
Keyword(s):  
Health Care Providers ◽  
Electronic Device ◽  
Electronic Devices ◽  
Implantable Cardioverter Defibrillators ◽  
Care Providers ◽  
Cardiac Implantable Electronic Devices ◽  
Device Implantation ◽  
Number Of Patients ◽  
History Of ◽  
Cardioverter Defibrillators

Implantation of cardiac implantable electronic devices (CIEDs), including pacemakers, implantable cardioverter-defibrillators, and biventricular pacemakers/cardioverter-defibrillators, is becoming increasingly common with new implants now exceeding 1.5 million per year globally. As a result, health care providers in all disciplines are caring for an increasing number of patients with CIEDs. Although the risk of complications associated with implantation of CIEDs is relatively low, the sequela can be catastrophic. Management requires an understanding of an individual patient’s indication for CIED implant, the steps of implant procedures, device function, and natural history of each complication.

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