scholarly journals Imaging of Cardiac Device-Related Infection

2021 ◽  
Vol 8 ◽  
Author(s):  
Jose Aguilera ◽  
Erika Hutt ◽  
Wael A. Jaber
Keyword(s):  
Computed Tomography ◽  
Tissue Characterization ◽  
Multimodality Imaging ◽  
Financial Burden ◽  
Laboratory Data ◽  
Diagnostic Tools ◽  
Prosthetic Material ◽  
International Consensus ◽  
Cardiac Device ◽  
Cardiac Devices

Cardiac devices are frequently used in different cardiovascular conditions for the purpose of morbidity or mortality prevention. These include cardiac implantable electronic devices (CIED) like permanent pacemakers and implantable cardiac defibrillators, ventricular assistance devices (VADs), left atrial appendage occlusion (LAAO) devices like the Watchman™, atrial and ventricular septal occluders like the Amplatzer™, among others. In the past years, there has been an increase in the development of these devices as a result of a rise in the number of indications for implantation, paired with the aging and more medically complex patient population. This has led to an increase in the incidence of cardiac device-related infections, one of the most feared and serious complications which is associated with significant morbidity, mortality and financial burden. Accurate diagnosis of cardiac device-related infections is essential given the management implications which often involve removal of the infected device, removal of other prosthetic material and long-term antimicrobial therapy. Clinical and laboratory data are useful diagnostic tools but multimodality imaging is often necessary. The recently published 2020 European Heart Rhythm Association International Consensus document, which is endorsed by many expert societies, has recommended the use of multimodality imaging for the diagnosis of CIED infections. (1) This allows better disease characterization by identifying abnormal fluid collections and guiding aspiration for both diagnostic and therapeutic purposes (i.e. soft tissue ultrasound and computed tomography), evaluation for local extent of disease (i.e. transesophageal echocardiogram to evaluate for concomitant infective endocarditis), embolic manifestation of disease (i.e. computed tomography and magnetic resonance imaging) and metabolic tissue characterization (positron emission tomography and tagged white blood cell scan). (2) In addition, computed tomography (CT) allows for pre-procedural planning which has shown to be associated with better procedural outcomes.

New frontiers in cardiac devices

2020 ◽  
Vol 81 (10) ◽  
pp. 92-103
Author(s):  
Adam SC Dennis ◽  
Jonathan M Behar
Keyword(s):  
Clinical Medicine ◽  
Heart Rhythm ◽  
Diagnostic Tools ◽  
Implantable Cardioverter Defibrillators ◽  
General Physician ◽  
Cardiac Device ◽  
Device Management ◽  
Cardiac Devices ◽  
Diagnostic Potential ◽  
Cardiac Resynchronisation

This article provides an overview of current cardiac device management, complications, and future areas for development. The last 70 years have seen huge advances in the field of implantable cardiac devices, from diagnostic tools to electrical therapies for bradycardia, ventricular arrhythmia and cardiac resynchronisation. While out-of-hours specialist cardiology cover and regional arrhythmia pathways are increasingly established, they are not universal, and the management of arrhythmia remains an important facet of clinical medicine for the general physician. This article discusses core recommendations from international guidelines with respect to heart rhythm diagnostics, pacing for bradycardia, cardiac resynchronisation and implantable cardioverter defibrillators, along with common complications. Finally, future innovations such as the diagnostic potential of portable technologies, antibiotic envelopes for cardiac devices and the increasing use of leadless pacemakers are described.

scholarly journals IMPLANTABLE CARDIAC DEVICE INFECTION - A CLINICAL AUDIT

2021 ◽  
Vol 70 (Suppl-4) ◽  
pp. S871-75
Author(s):  
Muhammad Asad ◽  
Qurban Hussain Khan ◽  
Mir Waqas Baloch ◽  
Kumail Abbas Khan ◽  
Muhammad Amer Naseem ◽  
...  
Keyword(s):  
Risk Factors ◽  
Infection Rate ◽  
Clinical Laboratory ◽  
Electronic Devices ◽  
Laboratory Data ◽  
Site Infection ◽  
Cardiac Device ◽  
Cardiac Implantable Electronic Devices ◽  
Cardiac Devices ◽  
Device Infection

Objective: Cardiac Implantable Electronic Devices are being implanted more commonly now compared to the past. Due to the rise in implantation rate complication have also considered to increase. One of the dreadful complications is devices infection. This study was conducted to assess retrospectively the rate of device infection and risk factors associated with it. Study Design: Observational study. Place and Duration of Study: AFIC/NIHD, Rawalpindi, from Jan 2018 to Jan 2019. Methodology: A total of 356 patients who underwent cardiac devices implantation. Their records were studied and all the patients who developed device infections were further reviewed in detail. Demographic details, clinical, laboratory data and imaging records were evaluated. Patients were classified into different categories of infections based on predefined criteria according to the guidelines. Risk factors were also taken into account. Results: Out of 356 devices 14 got infected and infection rate was 3.9%. Generator site infection was seen in 6 followed by generator erosion in 5 while 2 had pocket site infection with bacteremia and 1 developed pocket site infection with lead/valvular endocarditis. Dual chamber permanent pacemakers were infected the most. Denovo devices had high infection rate compared to replacement. Microbes were identified in 3 patients. Conclusions: Our findings suggest that the increasing incidence of Cardiac Implantable electronic devices infection in current clinical settings was multifactorial. Care should be taken at every step starting from preoperative, intraoperative to postoperative stage for prevention of device infection.

Automatic Remote Monitoring of Implantable Cardiac Devices in Clinical Practice – The Lumos-T Safely Reduces Routine Office Device Follow-up (TRUST) Trial

2010 ◽  
Vol 6 (3) ◽  
pp. 87
Author(s):  
Niraj Varma ◽  
Keyword(s):  
Clinical Practice ◽  
Remote Monitoring ◽  
Home Monitoring ◽  
Implantable Devices ◽  
Cardiac Device ◽  
Cardiac Devices ◽  
Enhance Patient Safety ◽  
Implantable Cardiac Devices ◽  
Post Implantation

The use of implantable electronic cardiac devices is increasing. Post-implantation follow-up is important for monitoring both device function and patient condition; however, clinical practice is inconsistent. For example, implantable cardioverter–defibrillator follow-up schedules vary from every three months to yearly according to facility and physician preference and the availability of resources. Importantly, no surveillance occurs between follow-up visits. By contrast, implantable devices with automatic remote monitoring capability provide a means for performing constant surveillance, with the ability to identify salient problems rapidly. The Lumos-T Reduces Routine Office Device Follow-up Study (TRUST) demonstrated that remote home monitoring reduced clinic burden and allowed early detection of patient and/or system problems, enabling efficient monitoring and an opportunity to enhance patient safety. The results of the trial have significant implications for the management of patients receiving all forms of implantable electronic cardiac device.

scholarly journals Radiological Findings in Multidetector Computed Tomography (MDCT) of Hereditary and Sporadic Pulmonary Veno-Occlusive Disease: Certainties and Uncertainties

Diagnostics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 141
Author(s):  
Marta Pérez Núñez ◽  
Sergio Alonso Charterina ◽  
Carmen Pérez-Olivares ◽  
Yolanda Revilla Ostolaza ◽  
Rafael Morales Ruiz ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Multidetector Computed Tomography ◽  
Poor Response ◽  
Occlusive Disease ◽  
Diagnostic Tools ◽  
Lung Edema ◽  
Consecutive Series ◽  
Radiological Findings ◽  
Vasodilator Treatment ◽  
Aggressive Clinical Course

Pulmonary veno-occlusive disease (PVOD) is a very infrequent form of pulmonary arterial hypertension with an aggressive clinical course, poor response to specific vasodilator treatment, and low survival. Confirming a definitive diagnosis is essential to guide treatment and assess lung transplantation. However, in the absence of histological or genetic confirmation, the diagnosis is complex, requiring a clinical suspicion. Multidetector computed tomography (MDCT) is an essential part of the non-invasive diagnostic tools of PVOD. We retrospectively reviewed the MDCT findings from a consecutive series of 25 patients diagnosed with PVOD, 9 with the sporadic form and 16 with the hereditary form of the disease. The presence and extent of typical findings of the diagnostic triad were assessed in all patients (ground glass parenchymal involvement, septal lines, and lymphadenopathy). In our series, 92% of patients showed at least two of the radiological findings described as typical of the disease. All patients presented at least one typical radiological characteristic. The incidence of radiological findings considered typical is very high, however was not associated with greater hemodynamic severity nor to the development of acute lung edema. No significant differences were found between the two groups. A poorly expressive MDCT does not exclude the disease.

scholarly journals Imaging Diagnosis of Right Ventricle Involvement in Chagas Cardiomyopathy

2017 ◽  
Vol 2017 ◽  
pp. 1-14 ◽  
Author(s):  
Minna M. D. Romano ◽  
Henrique T. Moreira ◽  
André Schmidt ◽  
Benedito Carlos Maciel ◽  
José Antônio Marin-Neto
Keyword(s):  
Right Ventricle ◽  
Tissue Characterization ◽  
Low Cost ◽  
Diagnostic Techniques ◽  
Diagnostic Tools ◽  
Deformation Analysis ◽  
Geometrical Shape ◽  
Gold Standard Method ◽  
Chagas Cardiomyopathy ◽  
Health And Disease

Right ventricle (RV) is considered a neglected chamber in cardiology and knowledge about its role in cardiac function was mostly focused on ventricular interdependence. However, progress on the understanding of myocardium diseases primarily involving the RV led to a better comprehension of its role in health and disease. In Chagas disease (CD), there is direct evidence from both basic and clinical research of profound structural RV abnormalities. However, clinical detection of these abnormalities is hindered by technical limitations of imaging diagnostic tools. Echocardiography has been a widespread and low-cost option for the study of patients with CD but, when applied to the RV assessment, faces difficulties such as the absence of a geometrical shape to represent this cavity. More recently, the technique has evolved to a focused guided RV imaging and myocardial deformation analysis. Also, cardiac magnetic resonance (CMR) has been introduced as a gold standard method to evaluate RV cavity volumes. CMR advantages include precise quantitative analyses of both LV and RV volumes and its ability to perform myocardium tissue characterization to identify areas of scar and edema. Evolution of these cardiac diagnostic techniques opened a new path to explore the pathophysiology of RV dysfunction in CD.

Noninvasive Tissue Characterization of Coronary Arterial Plaque by 16-Slice Computed Tomography in Acute Coronary Syndrome

Angiology ◽  
2006 ◽  
Vol 57 (2) ◽  
pp. 155-160 ◽  
Author(s):  
Kenichi Sakakura ◽  
Takanori Yasu ◽  
Yasuyuki Kobayashi ◽  
Takuji Katayama ◽  
Yoshitaka Sugawara ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Coronary Syndrome ◽  
Tissue Characterization ◽  
Coronary Syndrome ◽  
Arterial Plaque

scholarly journals Multi-detector computed tomography (MDCT) as a diagnostic tool in assessment of thoracic aortic anomalies in pediatric patients

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Dawlat Nader Eltatawy ◽  
Fatma Anas Elsharawy ◽  
Aly Aly Elbarbary ◽  
Raghda Ghonimy Elsheikh ◽  
Manal Ezzat Badawy
Keyword(s):  
Computed Tomography ◽  
Aortic Arch ◽  
Pediatric Patients ◽  
Interrupted Aortic Arch ◽  
Diagnostic Tools ◽  
Non Invasive ◽  
Branching Patterns ◽  
Anatomic Variants ◽  
Multi Detector Computed Tomography

Abstract Background A wide variety of congenital thoracic aortic variants and pathological anomalies could be assessed recently in diagnostic and interventional radiology. Multi-detector computed tomography (MDCT) is one of the most important non-invasive diagnostic tools for their detection. The aim of the study was to evaluate role of MDCT scanning for diagnosis of thoracic aortic anatomic variants and diseases in pediatric patients. Results Thirty patients (15 male and 15 female), mean age (8.49 ± 20.29 months) were diagnosed with different thoracic aortic anomalies by MDCT then confirmed by surgical results. MDCT was more sensitive than echocardiography in detection of hypo plastic arch, vascular rings, interrupted aortic arch anomalies, and aortic coarctation. Both MDCT and echocardiography showed 100% sensitivity in their detection of TGA, TOF, and PDA. MDCT detected 6 cases of right-sided aortic arch while echo missed 2 cases. Different aortic arch branching patterns and coronary origin were better demonstrated by MDCT. Conclusion 320-Multi-detector computed tomography is a reliable tool for optimal detection of thoracic aortic anomalies and preoperative planning.

scholarly journals Multimodality Imaging in Coronary Artery Disease: Focus on Computed Tomography

2016 ◽  
Vol 24 (1) ◽  
pp. 7 ◽  
Author(s):  
Ji Hyun Lee ◽  
Donghee Han ◽  
Ibrahim Danad ◽  
Bríain ó Hartaigh ◽  
Fay Y. Lin ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Multimodality Imaging ◽  
Artery Disease ◽  
Disease Focus

The Prevalence of Nephrolithiasis in Patients with Primary Gout: A Cross-sectional Study Using Helical Computed Tomography

2009 ◽  
Vol 36 (9) ◽  
pp. 1958-1962 ◽  
Author(s):  
TORU SHIMIZU ◽  
HIROSHI HORI
Keyword(s):  
Computed Tomography ◽  
Confidence Interval ◽  
Laboratory Data ◽  
Helical Computed Tomography ◽  
Cross Sectional ◽  
Patients Âgés ◽  
Primary Gout ◽  
Stone Formers ◽  
Significant Difference ◽  
History Of

Objective.To investigate the prevalence of nephrolithiasis in gouty patients by computed tomography (CT) imaging and to compare it with the “prevalence” of urolithiasis calculated from histories of urinary tract calculus.Methods.The kidneys of 383 male patients with primary gout were examined using an unenhanced 2-row helical CT detector, imaging at 2 mm collimation and a helical pitch of 3. The urolithiasis history of the 383 patients was investigated by inquiry. Patients’ ages, body mass index, and laboratory data from a 1-hour clearance test were determined.Results.CT scans confirmed nephrolithiasis in 103 (26.9%, 95% confidence interval 22.5%–31.6%) of the 383 gouty patients, and history of urinary calculus was positive in 65 (17.0%, 95% confidence interval 13.4%–21.1%) of the 383. However, 64 (62%) of the 103 stone-formers identified by CT had no history of urolithiasis. There was a significant difference between the ages of the 103 stone-formers identified by CT and the 65 stone-formers identified from the history.Conclusion.The prevalence of nephrolithiasis obtained using CT was 26.9% in the 383 patients with primary gout. Our results imply that we cannot determine an accurate prevalence of urolithiasis from a patient’s history. Most of the “prevalence” reported in the past may not correspond to a statistically justifiable one, but instead to the “cumulative incidence” during the contraction period of gout. Thus, the prevalence of nephrolithiasis confirmed by a cross-sectional method and the “prevalence” of urolithiasis calculated from patients’ calculus histories should be clearly distinguished.

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