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      Perioperative management for the prevention of bacterial infection in cardiac implantable electronic device placement

      review-article
      *
      Journal of Arrhythmia
      Elsevier
      Implantation technique, CIED complication, CIED infection

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          Abstract

          Cardiac implantable electronic devices (CIEDs) have become important in the treatment of cardiac disease and placement rates increased significantly in the last decade. However, despite the use of appropriate antimicrobial prophylaxis, CIED infection rates are increasing disproportionately to the implantation rate. CIED infection often requires explantation of all hardware, and at times results in death. Surgical site infection (SSI) is the most common cause of CIED infection as a pocket infection. The best method of combating CIED infection is prevention. Prevention of CIED infections comprises three phases: before, during, and after device implantation. The most critical factors in the prevention of SSIs are detailed operative techniques including the practice of proper technique by the surgeon and surgical team.

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          Most cited references28

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          Guideline for Hand Hygiene in Health-Care Settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force.

          The Guideline for Hand Hygiene in Health-Care Settings provides health-care workers (HCWs) with a review of data regarding handwashing and hand antisepsis in health-care settings. In addition, it provides specific recommendations to promote improved hand-hygiene practices and reduce transmission of pathogenic microorganisms to patients and personnel in health-care settings. This report reviews studies published since the 1985 CDC guideline (Garner JS, Favero MS. CDC guideline for handwashing and hospital environmental control, 1985. Infect Control 1986;7:231-43) and the 1995 APIC guideline (Larson EL, APIC Guidelines Committee. APIC guideline for handwashing and hand antisepsis in health care settings. Am J Infect Control 1995;23:251-69) were issued and provides an in-depth review of hand-hygiene practices of HCWs, levels of adherence of personnel to recommended handwashing practices, and factors adversely affecting adherence. New studies of the in vivo efficacy of alcohol-based hand rubs and the low incidence of dermatitis associated with their use are reviewed. Recent studies demonstrating the value of multidisciplinary hand-hygiene promotion programs and the potential role of alcohol-based hand rubs in improving hand-hygiene practices are summarized. Recommendations concerning related issues (e.g., the use of surgical hand antiseptics, hand lotions or creams, and wearing of artificial fingernails) are also included.
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            Update on cardiovascular implantable electronic device infections and their management: a scientific statement from the American Heart Association.

            Despite improvements in cardiovascular implantable electronic device (CIED) design, application of timely infection control practices, and administration of antibiotic prophylaxis at the time of device placement, CIED infections continue to occur and can be life-threatening. This has prompted the study of all aspects of CIED infections. Recognizing the recent advances in our understanding of the epidemiology, risk factors, microbiology, management, and prevention of CIED infections, the American Heart Association commissioned this scientific statement to educate clinicians about CIED infections, provide explicit recommendations for the care of patients with suspected or established CIED infections, and highlight areas of needed research.
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              ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices): developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons.

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                Author and article information

                Contributors
                Journal
                J Arrhythm
                J Arrhythm
                Journal of Arrhythmia
                Elsevier
                1880-4276
                1883-2148
                08 August 2015
                August 2016
                08 August 2015
                : 32
                : 4
                : 283-286
                Affiliations
                [0005]Department of Cardiovascular Surgery, Hiroshima University Hospital, Hiroshima, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
                Author notes
                [* ]Tel.: +81 82 257 5216; fax: +81 82 257 5219. kimai@ 123456hiroshima-u.ac.jp
                Article
                S1880-4276(15)00089-7
                10.1016/j.joa.2015.06.007
                4996848
                27588150
                a2b714d7-4d6f-4e71-923a-23760a91da71
                © 2015 Japanese Heart Rhythm Society

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 18 May 2015
                : 19 June 2015
                Categories
                Review

                implantation technique,cied complication,cied infection

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