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. 2016 Aug;32(4):303-7.
doi: 10.1016/j.joa.2015.09.006. Epub 2015 Nov 4.

Incidence of cardiac implantable electronic device infections and migrations in Japan: Results from a 129 institute survey

Hiroshi Nakajima  1 , Masami Taki  2
Affiliations

Incidence of cardiac implantable electronic device infections and migrations in Japan: Results from a 129 institute survey

Hiroshi Nakajima et al. J Arrhythm. 2016 Aug.

Abstract

Background: We conducted a survey of the infection burden associated with the implantation of cardiac implantable electronic devices (CIEDs) in Japan.

Methods: The institutes were selected using annual device implantation data provided by Medtronic Japan Co., Ltd. The data sampling period was from January 1 to December 31, 2013. Institutes were classified into Group P, at which only pacemakers were implanted, and Group A, at which other CIEDs were implanted. Group P was further classified into three sub-groups by implantation number. The infection rate was compared between groups using logistic regression analysis.

Results: A total of 129 of 138 institutes responded. The annual infection rate was 1.12% for overall CIEDs. The institute at which 15-29 pacemakers were implanted had a high infection rate (2.11%). No statistically significant difference was observed (adjusted p=0.1131). The overall migration rate was 0.50%. Complete removal of the CIED system was performed in 55.8% of patients who underwent implantation.

Conclusions: This survey was the first on CIED infection and migration in Japan. The CIED infection rate (1.12%) was similar to that previously reported. A high infection rate (2.77%) was observed in the infection experienced institutes.

Keywords: Cardiac implantable electronic device; Implantable cardioverter defibrillator; Infection; Lead extraction; Migration.

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Figures

Fig. 1
Fig. 1
Comparison of the Group P subgroups with Group A. Group P was classified into three sub-groups based on the number of implantations. Group P1 included the institutes in which less than 14 devices per year were implanted. Institutes at which 15–29 implantations were performed were classified as Group P2. The institutes at which more than 30 implantations were performed were classified as Group P3. The infection rate of Group P2 was 2.11%, and it was higher than that of the other groups and the infection rate in the US in 1996 ; dotted line. The infection rate in Group P2 was compared with that of the other groups using logistic regression analysis. The results of the analysis showed the inferiority of Group P2 to Group P3 with respect to the infection rate. However, no statistically significant difference was observed after Bonferroni correction.
Fig. 2
Fig. 2
Treatment of infection: Comparison of Group P with A. 50% of infections in Group P and 63% in Group A were treated with complete removal of the CIED system. There was no statistically significant difference between groups in the total removal rate. Overall complete removal rate was 56%.
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