Publication details

Mezinárodní konsenzus European Heart Rhythm Association (EHRA) o tom, jak předcházet infekcím implantabilních elektronických srdečních zařízení, diagnostikovat a léčit je. Souhrn dokumentu připravený Českou kardiologickou společností

Title in English European Heart Rhythm Association (EHRA) international consensus document on how to prevent, diagnose, and treat cardiac implantable electronic device infections. Summary of the document prepared by the Czech Society of Cardiology
Authors

TABORSKY Miloš KAUTZNER Josef NEUZIL Petr FEDORCO Marián WUNSCHOVA Hanka SEDIVA Lucie PYSZKO Jan SKALA Tomáš LATAL Jan NOVÁK Miroslav KOZÁK Milan KŘIVAN Lubomír GLOGER Vít BRECKA David KOLAR Milan

Year of publication 2020
Type Article in Periodical
Magazine / Source Cor et Vasa
MU Faculty or unit

Faculty of Medicine

Citation
Web https://e-coretvasa.cz/pdfs/cor/2020/03/06.pdf
Doi http://dx.doi.org/10.33678/cor.2020.059
Keywords Cardiac implantable electronic devices; Cardiac resynchronization therapy; EHRA consensus document; Endocarditis; Extraction; Implantable cardioverter-defibrillators; Infection; Leads; Microbiology; Pacemakers; Re-implantation
Description 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.

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