scholarly journals Practices of cardiac implantable electronic device follow-up: results of the European Heart Rhythm Association survey

EP Europace ◽  
2012 ◽  
Vol 14 (3) ◽  
pp. 423-425 ◽  
Author(s):  
G. Marinskis ◽  
L. van Erven ◽  
M. G. Bongiorni ◽  
G. Y. H. Lip ◽  
L. Pison ◽  
...  
Keyword(s):  
Electronic Device ◽  
Heart Rhythm ◽  
Cardiac Implantable Electronic Device

scholarly journals No substantial excess all-cause mortality among cardiac implantable electronic device patients during the first COVID‑19 lockdown in the Leiden area

2022 ◽  
Author(s):  
M. Feijen ◽  
A. D. Egorova ◽  
E. T. van der Velde ◽  
M. J. Schalij ◽  
S. L. M. A. Beeres
Keyword(s):  
Excess Mortality ◽  
Electronic Device ◽  
Cardiac Implantable Electronic Device ◽  
Strict Adherence ◽  
Chronic Heart Disease ◽  
Vulnerable Patients ◽  
All Cause Mortality ◽  
Complicated Course ◽  
Baseline Characteristics

AbstractIn the Netherlands, the coronavirus disease 2019 (COVID‑19) pandemic has resulted in excess mortality nationwide. Chronic heart disease patients are at risk for a complicated COVID‑19 course. The current study investigates all-cause mortality among cardiac implantable electronic device (CIED) patients during the first peak of the pandemic and compares the data to the statistics for the corresponding period in the two previous years. Data of adult CIED patients undergoing follow-up at the Leiden University Medical Centre were analysed. All-cause mortality between 1 March and 31 May 2020 was evaluated and compared to the data for the same period in 2019 and 2018. At the beginning of the first peak of the pandemic, 3,171 CIED patients (median age 70 years; 68% male; 41% ischaemic aetiology) were alive. Baseline characteristics of the 2019 (n = 3,216) and 2018 (n = 3,169) cohorts were comparable. All-cause mortality during the peak of the pandemic was 1.4% compared to 1.6% and 1.4% in the same period in 2019 and 2018, respectively (p = 0.84). During the first peak of the COVID‑19 pandemic, there was no substantial excess mortality among CIED patients in the Leiden area, despite the fact that this is group at high risk for a complicated course of a COVID‑19 infection. Strict adherence to the preventive measures may have prevented substantial excess mortality in these vulnerable patients.

scholarly journals European Heart Rhythm Association (EHRA) international consensus document on how to prevent, diagnose, and treat cardiac implantable electronic device infections—endorsed by the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS), the Latin American Heart Rhythm Society (LAHRS), International Society for Cardiovascular Infectious Diseases (ISCVID) and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)

EP Europace ◽  
2019 ◽  
Vol 22 (4) ◽  
pp. 515-549 ◽  
Author(s):  
Carina Blomström-Lundqvist ◽  
Vassil Traykov ◽  
Paola Anna Erba ◽  
Haran Burri ◽  
Jens Cosedis Nielsen ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Latin American ◽  
Electronic Device ◽  
Heart Rhythm ◽  
Asia Pacific ◽  
Cardiac Resynchronization ◽  
Cardiac Implantable Electronic Device ◽  
International Consensus ◽  
Consensus Document ◽  
Cardiac Resynchronization Therapy Devices

Abstract Pacemakers, implantable cardiac defibrillators, and cardiac resynchronization therapy devices are potentially life-saving treatments for a number of cardiac conditions, but are not without risk. Most concerning is the risk of a cardiac implantable electronic device (CIED) infection, which is associated with significant morbidity, increased hospitalizations, reduced survival, and increased healthcare costs. Recommended preventive strategies such as administration of intravenous antibiotics before implantation are well recognized. Uncertainties have remained about the role of various preventive, diagnostic, and treatment measures such as skin antiseptics, pocket antibiotic solutions, anti-bacterial envelopes, prolonged antibiotics post-implantation, and others. Guidance on whether to use novel device alternatives expected to be less prone to infections and novel oral anticoagulants is also limited, as are definitions on minimum quality requirements for centres and operators and volumes. Moreover, an international consensus document on management of CIED infections is lacking. The recognition of these issues, the dissemination of results from important randomized trials focusing on prevention of CIED infections, and observed divergences in managing device-related infections as found in an European Heart Rhythm Association worldwide survey, provided a strong incentive for a 2019 International State-of-the-art Consensus document on risk assessment, prevention, diagnosis, and treatment of CIED infections.

scholarly journals Clinical practice and implementation of guidelines for the prevention, diagnosis and management of cardiac implantable electronic device infections: results of a worldwide survey under the auspices of the European Heart Rhythm Association

EP Europace ◽  
2019 ◽  
Vol 21 (8) ◽  
pp. 1270-1279 ◽  
Author(s):  
Vassil Traykov ◽  
Maria Grazia Bongiorni ◽  
Giuseppe Boriani ◽  
Haran Burri ◽  
Roberto Costa ◽  
...  
Keyword(s):  
Preventive Measures ◽  
Electronic Device ◽  
Heart Rhythm ◽  
Initial Step ◽  
Needle Aspiration ◽  
Further Education ◽  
Cardiac Implantable Electronic Device ◽  
Infection Rates ◽  
Clinical Practices ◽  
Diagnosis And Management

Abstract Aims Cardiac implantable electronic device (CIED) infection rates are increasing. Worldwide compliance and disparities to published guidelines for the prevention, diagnosis and management of these conditions are not well elucidated. The purpose of this survey, therefore, was to clarify these issues through an inquiry to arrhythmia-related associations and societies worldwide. Methods and results A questionnaire comprising 15 questions related to CIED infections was distributed among members of seven arrhythmia societies worldwide. A total of 234 centres in 62 countries reported implantation rates of which 159 (68.0%) performed more than 200 device implantations per year and 14 (6.0%) performed fewer than 50 implantations per year. The reported rates of CIED infections for 2017 were ≤2% in 78.7% of the centres, while the infection rates exceeded 5% in 7.8% of the centres. Preventive measures for CIED infection differed from published recommendations and varied among different regions mainly in terms of pocket irrigation and administering post-operative antimicrobial therapy the use of which was reported by 39.9% and 44% of the respondents, respectively. Antibacterial envelopes were used by 37.7% of the respondents in selected circumstances. In terms of pocket infection management, 62% of the respondents applied complete system removal as an initial step. Diagnostic pocket needle aspiration and pocket surgical debridement were reported by 15.8% and 11.8% of centres, respectively. Conclusion Clinical practices for prevention and management of CIED do not fully comply with current recommendations and demonstrate considerable regional disparities. Further education and programmes for improved implementation of guidelines are mandatory.

scholarly journals European Heart Rhythm Association (EHRA) international consensus document on how to prevent, diagnose, and treat cardiac implantable electronic device infections—endorsed by the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS), the Latin American Heart Rhythm Society (LAHRS), International Society for Cardiovascular Infectious Diseases (ISCVID) and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)

2019 ◽  
Vol 57 (1) ◽  
pp. e1-e31 ◽  
Author(s):  
Carina Blomström-Lundqvist ◽  
Vassil Traykov ◽  
Paola Anna Erba ◽  
Haran Burri ◽  
Jens Cosedis Nielsen ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Latin American ◽  
Electronic Device ◽  
Heart Rhythm ◽  
Asia Pacific ◽  
Cardiac Resynchronization ◽  
Cardiac Implantable Electronic Device ◽  
International Consensus ◽  
Consensus Document ◽  
Cardiac Resynchronization Therapy Devices

Abstract Pacemakers, implantable cardiac defibrillators, and cardiac resynchronization therapy devices are potentially life-saving treatments for a number of cardiac conditions, but are not without risk. Most concerning is the risk of a cardiac implantable electronic device (CIED) infection, which is associated with significant morbidity, increased hospitalizations, reduced survival, and increased healthcare costs. Recommended preventive strategies such as administration of intravenous antibiotics before implantation are well recognized. Uncertainties have remained about the role of various preventive, diagnostic, and treatment measures such as skin antiseptics, pocket antibiotic solutions, anti-bacterial envelopes, prolonged antibiotics post-implantation, and others. Guidance on whether to use novel device alternatives expected to be less prone to infections and novel oral anticoagulants is also limited, as are definitions on minimum quality requirements for centres and operators and volumes. Moreover, an international consensus document on management of CIED infections is lacking. The recognition of these issues, the dissemination of results from important randomized trials focusing on prevention of CIED infections, and observed divergences in managing device-related infections as found in an European Heart Rhythm Association worldwide survey, provided a strong incentive for a 2019 International State-of-the-art Consensus document on risk assessment, prevention, diagnosis, and treatment of CIED infections.

scholarly journals Management of cardiac implantable electronic device follow‐up in COVID‐19 pandemic: Lessons learned during Italian lockdown

2020 ◽  
Vol 31 (11) ◽  
pp. 2814-2823 ◽  
Author(s):  
Agostino Piro ◽  
Michele Magnocavallo ◽  
Domenico Giovanni Della Rocca ◽  
Matteo Neccia ◽  
Giovanna Manzi ◽  
...  
Keyword(s):  
Electronic Device ◽  
Lessons Learned ◽  
Cardiac Implantable Electronic Device

Variations in cardiac implantable electronic device surveillance and ancillary testing in the paediatric and congenital heart disease population: an international multi-centre survey from the Paediatric and Congenital Electrophysiology Society

2021 ◽  
pp. 1-5
Author(s):  
Melissa M. Olen ◽  
Brynn E. Dechert ◽  
Anne Foster ◽  
Ronald J. Kanter ◽  
Michael J. Silka ◽  
...  
Keyword(s):  
Remote Monitoring ◽  
Electronic Device ◽  
Stress Test ◽  
Exercise Stress Test ◽  
Exercise Stress ◽  
Implantable Cardioverter Defibrillators ◽  
Cardiac Implantable Electronic Device ◽  
Clinical Practices ◽  
Device Implantation

Abstract Background: Expert guidance from scientific societies and regulatory agencies recommend a framework of principles for frequency of in-person evaluations and remote monitoring for patients with cardiac implantable electronic devices. However, there are limited data regarding adherence to recommendations among paediatric electrophysiologists, and there are no data regarding cardiac implantable electronic device-related ancillary testing. Methods: To assess current clinical practices for cardiac implantable electronic device in-person evaluation, remote monitoring, and cardiac implantable electronic device-related ancillary testing, the Paediatric and Congenital Electrophysiology Society members were surveyed. The main outcome measures were variations in frequency of in person evaluation, frequency of remote monitoring, and cardiac implantable electronic device-related ancillary testing. Results: All respondents performed in-person evaluation at least once a year, but <50% of respondents performed an in-person evaluation within 2 weeks of cardiac implantable electronic device implantation. Remote monitoring was performed every 3 months for pacemakers and implantable cardioverter defibrillators by 71 and 75% respondents, respectively. Follow-up echocardiography was performed every 2–3 years by 53% respondents for patients with >50% ventricular pacing. Majority of respondents (75%) did not perform either an exercise stress test or ambulatory Holter monitoring or chest X-ray (65%) after cardiac implantable electronic device implantation. Conclusion: This survey identified significant practice variations in cardiac implantable electronic device in- person evaluation, remote monitoring, and ancillary testing practices among paediatric electrophysiologists. Cardiac implantable electronic device management may be optimised by development of a paediatric-specific guidelines for follow-up and ancillary testing.

scholarly journals Outcomes of Patients Who Have Incidental Non-Sustained Ventricular Tachycardia Identified on Cardiac Implantable Electronic Device Interrogation

Hearts ◽  
2021 ◽  
Vol 2 (3) ◽  
pp. 294-301
Author(s):  
Aditya Narain ◽  
Chun Shing Kwok ◽  
Caterina Liggett-Wright ◽  
Joseph Mayer ◽  
Daniel Darlington ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Hospital Mortality ◽  
Medication Review ◽  
Electronic Device ◽  
Clinical Audit ◽  
Sustained Ventricular Tachycardia ◽  
Single Center ◽  
Cardiac Implantable Electronic Device

Background: Non-sustained ventricular tachycardia (NSVT) is an arrhythmia prevalent in both structurally normal and abnormal hearts. Methods: We conducted a single-center retrospective clinical audit of patients followed-up in a device clinic with one or more incidental NSVT episodes recorded on their device between November 2017 and August 2018 and followed up patients for outcomes until January 2019. Results: A total of 83 patients were included in the analysis with one or more episodes of NSVT on device interrogation. Those identified to have NSVT were more likely to be male (74.7%) and there was a mean of 14.2 beats per episode and a mean of 3.7 episodes for each patient. Only 24.7% of patients had electrolytes checked within 4 weeks of episode detection and 18.3% had an echocardiogram post-episode. The majority of patients (73.5%) were followed up again in the pacing clinic but had no changes in medication, or other management implemented. In terms of outcomes, 81.7% of patients had no admission to hospital, mortality, or shock during the follow-up period. Conclusions: Most patients who developed NSVT did not have an extra follow-up, medication review, or investigation. Despite this, outcomes such as admission, shock, or death were uncommon.

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