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. 2016 May;5(1):65-71.
doi: 10.15420/aer.2015.27.2.

Cardiac Implantable Electronic Device Infection in Patients at Risk

Khaldoun G Tarakji  1 , Christopher R Ellis  2 , Pascal Defaye  3 , Charles Kennergren  4
Affiliations

Cardiac Implantable Electronic Device Infection in Patients at Risk

Khaldoun G Tarakji et al. Arrhythm Electrophysiol Rev. 2016 May.

Abstract

The incidence of infection following implantation of cardiac implantable electronic devices (CIEDs) is increasing at a faster rate than that of device implantation. Patients with a CIED infection usually require hospitalisation and complete device and lead removal. A significant proportion die from their infection. Transvenous lead extraction (TLE) is associated with rare but serious complications including major vascular injury or cardiac perforation. Operator experience and advances in lead extraction methods, including laser technology and rotational sheaths, have resulted in procedures having a low risk of complication and mortality. Strategies for preventing CIED infections include intravenous antibiotics and aseptic surgical techniques. An additional method to reduce CIED infection may be the use of antibacterial TYRX™ envelope. Data from non-randomised cohort studies have indicated that antibacterial envelope use can reduce the incidence of CIED infection by more than 80 % in high-risk patients and a randomised clinical trial is ongoing.

Keywords: Cardiovascular implantable electronic device infections; antibacterial envelope; implantable cardioverter-defibrillators; pacemaker; transvenous lead extraction.

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Figures

Figure 1:
Figure 1:. Images of Pocket Infection Over Two Years
Figure 2:
Figure 2:. Causes of Cardiac Implantable Electronic Devices Infection Mortality
Figure 3:
Figure 3:. Kaplan-Meier Survival Curves for One-year Mortality Among Patients with Cardiac Implantable Electronic Devices Undergoing Transvenous Lead Extraction
Figure 4:
Figure 4:. The TYRX™ Absorbable Antibacterial Envelope
Figure 5:
Figure 5:. Efficacy of TYRX™ Antibacterial Envelope in High-risk Subjects
See this image and copyright information in PMC

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