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)
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- Carina Blomström-Lundqvist
- Department of Medical Science and Cardiology, Uppsala University, Uppsala, Sweden
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- Vassil Traykov
- Department of Invasive Electrophysiology and Cardiac Pacing, Acibadem City Clinic Tokuda Hospital, Sofia, Bulgaria
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- Paola Anna Erba
- Nuclear Medicine, Department of Translational Research and New Technology in Medicine, University of Pisa, Pisa, Italy, and University of Groningen, University Medical Center Groningen, Medical Imaging Center, Groningen, The Netherlands
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- Haran Burri
- Department of Cardiology, University Hospital of Geneva, Geneva, Switzerland
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- Jens Cosedis Nielsen
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
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- Maria Grazia Bongiorni
- Division of Cardiology and Arrhythmology, CardioThoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy
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- Jeanne Poole
- Division of Cardiology, University of Washington, Seattle, WA, USA
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- Giuseppe Boriani
- Division of Cardiology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
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- Roberto Costa
- Department of Cardiovascular Surgery, Heart Institute (InCor) of the University of São Paulo, São Paulo, Brazil
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- Jean-Claude Deharo
- Department of Cardiology, Aix Marseille Université, CHU la Timone, Marseille, France
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- Laurence M Epstein
- Electrophysiology, Northwell Health, Hofstra/Northwell School of Medicine, Manhasset, NY, USA
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- Laszlo Saghy
- Division of Electrophysiology, 2nd Department of Medicine and Cardiology Centre, University of Szeged, Szeged, Hungary
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- Ulrika Snygg-Martin
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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- Christoph Starck
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
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- Carlo Tascini
- First Division of Infectious Diseases, Cotugno Hospital, Azienda ospedaliera dei Colli, Naples, Italy
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- Neil Strathmore
- Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia
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説明
<jats:title>Abstract</jats:title> <jats:p>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.</jats:p>
収録刊行物
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- EP Europace
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EP Europace 22 (4), 515-549, 2019-11-08
Oxford University Press (OUP)