Background: The rise in the incidence of implantation is one of the main causes behind the increased rate of CIED infection, which is considered as a serious life-threatening complication. The need of risk factor assessment has become a necessity to prevent further complications and provide prompt management.
Objectives: Identify the risk factors of infection postoperatively among patients who have implantable cardiac devices.
Design: A retrospective case-control study.
Settings: Cardiac center for adults.
Patients And Methods: The study included all adult patients (≥14 years of age) of all nationalities who underwent cardiac electronic device implantation that was managed in the cardiac center between January 2012 to December 2018.
Main Outcome Measures: Cardiac device infection and associated risk factors.
Sample Size: 213, including 23 (10.8%) infected case patients and 190 (89.2%) non-infected controls.
Results: The mean (SD) age of non-infected patients was 45.0 (12.7) years compared with 61.7 (13.7) for infected patients (P<.0001). Anticoagulant use, hypertension, dysplipdemia and age were the most common patient-related risk factors associated with infection. For procedural and post-procedural risk factors, the risk of infection increased as the number of leads and length of procedure increased. The device most often related to infection was the pacemaker. In the multivariate analysis, longer procedure, greater number of leads, older age, anticoagulant use, and implanted pacemaker device were independently associated with infection.
Conclusion: We advise the prompt use of strict preoperative antiseptic prophylaxis measures and follow-up for post-implant patients along with patient education for early signs of infections, which will lead to improvement of both diagnosis and treatment quality for our patients in addition to reducing the economic impact on the health care system by minimizing infectious complications.
Limitations: Single tertiary center study, small sample size.
Conflict Of Interest: None.
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http://dx.doi.org/10.5144/0256-4947.2022.58 | DOI Listing |
Indian Pacing Electrophysiol J
January 2025
Royal Jubilee Hospital, Vancouver Island Health Authority, British Columbia, Canada.
Transthyretin Cardiac amyloidosis (ATTR-CA) is an increasingly recognised cause of heart failure in our elderly patients with preserved ejection fraction. Patients with ATTR-CA who require permanent pacemaker implantation often have preserved ejection fraction and do not meet the clinical indication for cardiac resynchronization therapy (CRT). In these patients, left bundle branch area pacing (LBBAP) can be a reasonable option to maximise physiological activation of the left ventricle.
View Article and Find Full Text PDFGen Hosp Psychiatry
December 2024
Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; Division of Patient Safety, Keio University School of Medicine, Tokyo, Japan. Electronic address:
Objectives: Treatment decisions for severe aortic stenosis (AS) are complex, since there are two active and comparable options: transcatheter aortic valve implantation and surgical aortic valve replacement. The disease predominantly affects older individuals, who are frequently comorbid with from cognitive impairment. This study aimed to establish a screening-triggered system to assess the decision-making capacity of patients with AS, support their decision-making, and facilitate referrals to specialists when necessary.
View Article and Find Full Text PDFACS Nano
January 2025
School of Mechanical and Manufacturing Engineering, University of New South Wales, Sydney, New South Wales 2052, Australia.
Implantable systems with chronic stability, high sensing performance, and extensive spatial-temporal resolution are a growing focus for monitoring and treating several diseases such as epilepsy, Parkinson's disease, chronic pain, and cardiac arrhythmias. These systems demand exceptional bendability, scalable size, durable electrode materials, and well-encapsulated metal interconnects. However, existing chronic implantable bioelectronic systems largely rely on materials prone to corrosion in biofluids, such as silicon nanomembranes or metals.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
Background: Mild Behavioral Impairment (MBI) is a condition characterized by neuropsychiatric symptoms (NPS) in older adults without dementia, serving as a precursor to various forms of dementia. This study explores the association between NPS and functional connectivity (FC) within the default mode network (DMN), executive control network (ECN), and salience network (SN) across three high-risk cohorts: mild cognitive impairment (due to Alzheimer's) (MCI, n = 79), cerebrovascular disease (CVD, n = 144), and Parkinson's disease (PD, n = 132).
Method: A total of 367 participants were recruited from the Ontario Neurodegenerative Disease Research Initiative (ONDRI).
Curr Opin Cardiol
December 2024
Division of Cardiac Surgery, Department of Surgery, Western University, London, Ontario, Canada.
Purpose Of Review: Management of tricuspid regurgitation and annular dilation during mitral valve repair remains controversial. We review the latest evidence on indications to repair the tricuspid valve during mitral valve repair and discuss surgical strategies and complications.
Recent Findings: Concomitant tricuspid valve repair of moderate tricuspid regurgitation is effective in reducing tricuspid regurgitation progression at 2 years, but has not shown benefit to late survival, quality of life, or functional benefit, and is associated with increased permanent pacemaker implantation (PPM) rates, which is associated with reduced late survival.
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