SİNGLE CENTER EXPERİENCE WİTH CARDİAC DEVİCE INFECTİON: IMPORTANCE OF PERİPROCEDURAL PRECAUTİONS

Abstract

OBJECTİVE Cardiac implantable electronic devices (CIED) have been increasingly used in recent years; consequently there has been an increment in device-related complications. The rates of CIED infection vary widely in the literature therefore we need more standardizations on our laboratories. In this study, we aimed to give a suggestion to the centers which can implant cardiac devices about the perioperative measures and to reinforce the role of perioperative measures in preventing cardiac device infection. MATHERİALS and METHODS This single-center study was carried out in the Cardiology Clinic of the 29 Mayıs State Hospital, Ankara City, Turkey from November 1, 2019 to June 30, 2020. In the retrospective review, the demographic data, medical diagnoses, operation details, echocardiographic findings, anticoagulant/ antiaggregant usement and complications (Table 1), laboratory findings and comorbidities (Table 2) of the patients were examined. No distinction was made between device types. 90-day and 30-day retrospective screenings were performed. Patients were called for control visits at 1-week and 1-month following the procedure. 3-month checks were made over telecommunication methods. RESULTS 169 people were enrolled in the study. 60(35,5) patients were admitted from the emergency department. A pacemaker was implanted in 60 patients, an implantable cardioverter-defibrillator (ICD) in 79 patients, and a Cardiac Resynchronization Therapy (CRT) in 30 patients. CIED implantation was performed for the first time in 114 patients, battery replacement in 41 patients and lead implantation and battery replacement in 13 patients. Aesthetic sutures were applied in 93.4% of the patients, and matrix sutures were applied to the others. Subcutaneous sutures of all patients were closed with continuous sutures. In the analysis performed by excluding battery replacements, the procedure time of patients with CRT implantation was significantly longer (p <0.001). However, no statistical difference was found in infection rates. Battery pocket hematoma was observed in 4 patients and suspected battery pocket infection in 1 patient. CONCLUSİON We think that low rate of CIED infection in our clinic is a result of strict periprocedural measures and collaborating with infectious diseases.