Implantation Success and Infection in Cardiovascular Implantable Electronic Device Procedures Utilizing an Antibacterial Envelope
Implantation Success and Infection in Cardiovascular Implantable Electronic Device Procedures Utilizing an Antibacterial Envelope
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DOI：
10.1111/j.1540-8159.2010.02931.x
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发表时间：
2011-02-01
影响因子：
1.8
通讯作者：
Sohail, Muhammad R.
中科院分区：
文献类型：
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作者：
Bloom, Heather L.;Constantin, Luis;Sohail, Muhammad R.
研究方法：本研究在10个美国学术、社区和退伍军人事务部医疗中心招募了使用抗菌信封的连续CIED手术。排除了先前CIED感染或抗菌信封标签外使用的预防后的程序。624个合格程序（年龄70 ± 13岁，68.1%男性，27.2%肾功能不全，35.4%口服抗凝剂使用，67.8%置换/翻修手术）使用起搏器（35%），植入式心律转复除颤器（ICD）（29%），心脏除颤器（CRT-D）治疗（36%）。近一半的患者（49%）至少有三个预先确定的CIED感染风险因素。CIED植入在621例手术中获得成功（99.5% [95%置信区间（CI）98.8-99.9]）。在1.9 +/- 2.4个月随访后，有3例严重感染（0.48% [95%CI 0.17-1.40]）。感染发生在1例ICD翻修和2例CRT-D置换后。有7人死亡;结论：使用抗菌包膜的CIED手术具有较高的CIED植入成功率（> 99%）。虽然随访时间较短，但在CIED感染高危人群中，感染率也较低（< 0.50%）。(PACE 2011; 34：133-142）。
Methods: This study enrolled consecutive CIED procedures utilizing the antibacterial envelope at 10 US academic, community, and Veterans Affairs medical centers. Procedures following an explantation for a prior CIED infection or off-label use of the antibacterial envelope were excluded.Results: The 624 eligible procedures (age 70 +/- 13 years, 68.1% men, 27.2% renal insufficiency, 35.4% oral anticoagulant use, 67.8% replacement/revision procedures) utilized pacemakers (35%), implantable cardioverter-defibrillators (ICD)(29%), and cardiac resynchronization therapy with defibrillator devices (CRT-D)(36%). Nearly half of the patients (49%) had at least three predefined risk factors for CIED infection. CIED implantation was successful in 621 procedures (99.5% [95% confidence interval (CI) 98.8-99.9]). There were three major infections (0.48% [95%CI 0.17-1.40]) after 1.9 +/- 2.4 months follow-up. The infections followed one ICD revision and two CRT-D replacements. There were seven deaths; none was a result of the antibacterial envelope or the CIED procedure.Conclusions: CIED procedures that utilized an antibacterial envelope had a high rate of CIED implantation success (> 99%). Although the follow-up to date is short, there was also a low rate of infection (< 0.50%) in this population at high risk for CIED infection. (PACE 2011; 34:133-142).