Abstract
AimsTo determine the frequency, characteristics and risk factors of cardiac device infections in the Isala Hospital.MethodsWe retrospectively studied all patients who underwent cardiac device procedures performed in the cardiac catheterisation lab and the operating room from 2010 to 2012. All patients who developed a cardiac device infection were reviewed for its characteristics.Results31/2026 patients developed a cardiac device infection (1.5 %). One (3.2 %) patient died within 30 days of hospitalisation. Device infection rates for procedures in the catheterisation lab and operating room were similar (p = 0.60). Positive cultures were present in 27/31 (87 %) cases. These consisted predominantly of micro-organisms that are part of the skin flora (84 %). The mean time between device procedure and infection was 14 ± 21 months (range 0–79). Cardiac device infection was significantly associated with device revision, (65 % were revisions in patients with device infection vs. 30 % revisions in patients without device infection, p = 0.011) and placement of a left ventricular lead in pacemaker implantations (59 % of patients with vs. 51 % of patients without device infection, p < 0.001).ConclusionThe frequency of cardiac device infection was 1.5 % with a mortality of 3.2 % within 30 days, which is lower compared with other registries. Cardiac device infections were associated with device revisions and placement of left ventricular leads in pacemaker implantations.
Highlights
The relative number of cardiac device infections is rising together with an increase in device implantations [1,2,3]
Risk factors associated with device infections are the number of previous device procedures, renal insufficiency, post-procedural haematoma, fever < 24 h after the procedure, and complexity and duration of the procedure [1, 4, 5]
Due to the rising number of cardiac device infections, a nationwide program was initiated from the National Society of Cardiology (NVVC) in the Netherlands in 2008 in order to reduce the incidence along with its morbidity and mortality rates
Summary
The relative number of cardiac device infections is rising together with an increase in device implantations [1,2,3]. Cardiac device infection is associated with substantial morbidity and mortality [1, 2]. The Isala is a large volume tertiary care heart centre, with advanced experience in the management of cardiac device complications, including infections. Due to the rising number of cardiac device infections, a nationwide program was initiated from the National Society of Cardiology (NVVC) in the Netherlands in 2008 in order to reduce the incidence along with its morbidity and mortality rates. Our main goal was to examine the frequency, characteristics and possible risk factors for cardiac device infections in our large volume centre
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