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Shawon MSR, Sotade OT, Li J, Hill MD, Strachan L, Challis G, King K, Ooi SY, Jorm L. Factors associated with cardiac implantable electronic device-related infections, New South Wales, 2016-21: a retrospective cohort study. Med J Aust 2024; 220:510-516. [PMID: 38711337 DOI: 10.5694/mja2.52302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 01/22/2024] [Indexed: 05/08/2024]
Abstract
OBJECTIVES To quantify the rate of cardiac implantable electronic device (CIED)-related infections and to identify risk factors for such infections. DESIGN Retrospective cohort study; analysis of linked hospital admissions and mortality data. SETTING, PARTICIPANTS All adults who underwent CIED procedures in New South Wales between 1 January 2016 and 30 June 2021 (public hospitals) or 30 June 2020 (private hospitals). MAIN OUTCOME MEASURES Proportions of patients hospitalised with CIED-related infections (identified by hospital record diagnosis codes); risk of CIED-related infection by patient, device, and procedural factors. RESULTS Of 37 675 CIED procedures (23 194 men, 63.5%), 500 were followed by CIED-related infections (median follow-up, 24.9 months; interquartile range, 11.2-40.8 months), including 397 people (1.1%) within twelve months of their procedures, and 186 of 10 540 people (2.5%) at high risk of such infections (replacement or upgrade procedures; new cardiac resynchronisation therapy with defibrillator, CRT-D). The overall infection rate was 0.50 (95% confidence interval [CI], 0.45-0.54) per 1000 person-months; it was highest during the first month after the procedure (5.60 [95% CI, 4.89-6.42] per 1000 person-months). The risk of CIED-related infection was greater for people under 65 years of age than for those aged 65-74 years (adjusted hazard ratio [aHR], 1.71; 95% CI, 1.32-2.23), for people with CRT-D devices than for those with permanent pacemakers (aHR, 1.46; 95% CI, 1.02-2.08), for people who had previously undergone CIED procedures (two or more v none: aHR, 1.51; 95% CI, 1.02-2.25) or had CIED-related infections (aHR, 11.4; 95% CI, 8.34-15.7), or had undergone concomitant cardiac surgery (aHR, 1.62; 95% CI, 1.10-2.39), and for people with atrial fibrillation (aHR, 1.33; 95% CI, 1.11-1.60), chronic kidney disease (aHR, 1.54; 95% CI, 1.27-1.87), chronic obstructive pulmonary disease (aHR, 1.37; 95% CI, 1.10-1.69), or cardiomyopathy (aHR 1.60; 95% CI, 1.25-2.05). CONCLUSIONS Knowledge of risk factors for CIED-related infections can help clinicians discuss them with their patients, identify people at particular risk, and inform decisions about device type, upgrades and replacements, and prophylactic interventions.
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Affiliation(s)
| | | | - Joan Li
- Prince of Wales Hospital, Sydney, NSW
| | | | | | | | - Kate King
- Medtronic Australasia Pty Ltd, Sydney, NSW
| | | | - Louisa Jorm
- Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW
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2
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Richardson CJ, Prempeh J, Gordon KS, Poyser TA, Tiesenga F. Surgical Techniques, Complications, and Long-Term Health Effects of Cardiac Implantable Electronic Devices. Cureus 2021; 13:e13001. [PMID: 33659133 PMCID: PMC7920239 DOI: 10.7759/cureus.13001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Cardiovascular implantable electronic device (CIED) has helped with advanced technological improvement in the cardiac field and has been a long-term alternative to medical management. There are different forms of CIEDs such as pacemakers, implantable cardioverter-defibrillators, and cardiac resynchronization therapy. These devices are efficient in establishing near-normal hemodynamics and circulation that ultimately aid physicians to improve the quality of life for their patients. However, there are risk factors that can result in postoperative complications, including infection, lead and pulse generator complications, heart complications, medication-related complications, and psychosocial complications. To ensure optimal outcome of CIED placement, preprocedural measures need to be in place such as matching the right candidate and using appropriate devices. This review aims to highlight the surgical techniques for CIEDs, the associated postoperative complications, and long-term health effects.
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Affiliation(s)
| | - John Prempeh
- Internal Medicine, Saint James School of Medicine, The Quarter, AIA
| | - Kyle S Gordon
- Internal Medicine, American University of Antigua, Osburn, ATG
| | - Tracy-Ann Poyser
- Internal Medicine, Windsor University School of Medicine, Cayon, KNA
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Salvage of Exposed Cardiac Implants Using Fasciocutaneous Rotation Flaps. Ann Plast Surg 2021; 84:85-89. [PMID: 31524640 DOI: 10.1097/sap.0000000000001985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Implantation rates of cardiac implantable electrophysiological devices (CIEDs) are rising, mainly because of the expansion of implantable cardioverter-defibrillators indications for primary prevention. As the CIED usage increases, CIED-related complications are also in rise. Transvenous approach and laser utilization techniques are replacing the open heart surgeries, for removal of CIED systems that are suspected to be infected. In this study, we aimed to share our new method of fasciocutaneous flap coverage results of patients with exposed CIED systems who were not eligible for the CIED replacement surgery for various reasons. PATIENTS AND METHODS Patients operated with rotational fasciocutaneous flaps with addition of pectoralis fascia, owing to their exposed CIEDs between June 2016 and January 2019, were enlisted. Patients with signs of infection whether systemic or limited to the CIED pocket with or without positive blood cultures were referred to infectious diseases department and not included in this study. Patients included in the study were evaluated retrospectively in terms of demographic data, implanted CIED type, time elapsed from implantation to exposure, from referral to flap coverage operation, total follow-up time, survival ratios during follow-up, and complications related to flap coverage operation. In addition, indications for CIED implantation, patient comorbidities, and culture results obtained from the capsule encompassing the CIED battery unit were included to the evaluation. RESULTS A total of 13 patients with exposed CIEDs have undergone total capsulectomy and CIED system coverage with rotational fasciocutaneous flaps. The mean patient age ± SD was 60.2 ± 13.4 years. The average time elapsed from CIED implantation to exposure was 27.3 ± 15.4 months. The average time spanned from initial referral to operation was 6 ± 1.6 days. The most prevalent comorbidity was diabetes mellitus. The average time elapsed during operation for pectoral fascia incorporated rotation flaps was 90 ± 10.6 minutes. Coagulase negative staphylococci were the dominant species (46.5%) obtained from capsule cultures. Apart from 1 case of hematoma, no early or late operation-related complication was encountered. CONCLUSIONS A more precise definition of contamination and infection has to be made in guidelines, which may lead the first group to be treated without extraction. Surgical method defined in this study can be used for the treatment of patients in contaminated CIED subgroup, conserving individuals from risks of device extraction.
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Goel V, Kumar V, Agrawal SN, Patwardhan AM, Ibrahim M, DeSimone DC, Sivanesan E, Banik RK, Shankar H. Outcomes Associated With Infection of Chronic Pain Spinal Implantable Electronic Devices: Insights From a Nationwide Inpatient Sample Study. Neuromodulation 2020; 24:126-134. [PMID: 32929856 DOI: 10.1111/ner.13263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 07/26/2020] [Accepted: 08/03/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Chronic pain spinal implantable electronic devices (CPSIEDs) include devices that provide spinal cord stimulation and intrathecal drug therapy. In this study, we sought to evaluate the trends of CPSIED infections, related complications, and outcomes following the treatment of infection. MATERIALS AND METHODS The Nationwide Inpatient Sample database contains data from 48 states, and the District of Columbia was used to identify patients with a primary diagnosis of CPSIED infection during the years 2005-2014. Patients with intrathecal pumps for the treatment of spasticity were excluded to limit the study population to patients with chronic pain disorders. Treatments were categorized as: 1) without device removal, 2) pulse generator or pump only removal, 3) intrathecal pump system removal, and 4) spinal cord stimulation system removal. Complications associated with CPSIED infections were identified using administrative billing codes. RESULTS During the study period 2005-2014, a total of 11,041 patients were admitted to the hospital with CPSIED infections. The majority of the patients were treated without surgical intervention (56%), and a smaller proportion underwent complete system explantation (22.7%). In-hospital mortality or permanent disability due to paralysis after CPSIED infection was around 1.83% and 2.77%, respectively. Infectious complications such as meningitis, abscess formation, and osteomyelitis occurred in 4.93%, 5.08%, and 1.5%, respectively. The median cost of hospitalization was around US $14,118.00, and the median length of stay was approximately six days (interquartile range = 4-13 days). CONCLUSIONS The complications of CPSIED infection were higher among patients that did not undergo device removal.
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Affiliation(s)
- Vasudha Goel
- Department of Anesthesiology, University of Minnesota, Minneapolis, MN, USA
| | - Varun Kumar
- Department of Neurology, University of South Florida, Tampa, FL, USA
| | | | - Amol M Patwardhan
- Department of Anesthesiology, University of Arizona, Tucson, AZ, USA
| | - Mohab Ibrahim
- Department of Anesthesiology, University of Arizona, Tucson, AZ, USA
| | - Daniel C DeSimone
- Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, MN, USA.,Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Eellan Sivanesan
- Department of Anesthesiology, Johns Hopkins University, Baltimore, MD, USA
| | - Ratan K Banik
- Department of Anesthesiology, University of Minnesota, Minneapolis, MN, USA
| | - Hariharan Shankar
- Department of Anesthesiology, Clement Zablocki VA Medical Center, Medical College of Wisconsin, Milwaukee, WI, USA
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Suarez K, Banchs JE. A Review of Temporary Permanent Pacemakers and a Comparison with Conventional Temporary Pacemakers. J Innov Card Rhythm Manag 2019; 10:3652-3661. [PMID: 32477730 PMCID: PMC7252718 DOI: 10.19102/icrm.2019.100506] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 11/28/2018] [Indexed: 11/06/2022] Open
Abstract
Temporary cardiac pacing is commonly used in patients with life-threatening bradycardia and serves as a bridge to implantation of a permanent pacemaker (PPM). For years, passive fixation leads have been used for this purpose, offering the advantage of that they can be placed at bedside. The downside, however, is that patients must remain on telemetry and bed rest until lead removal due to the risk of displacement and failure to capture. Even then, the latter cannot always be prevented. Temporary cardiac pacing with passive fixation leads has also been related to a higher incidence of infection and venous thrombosis, delayed recovery, and increased length of stay. Thus, over the last couple of decades, pacemaker leads with an active fixation mechanism have become increasingly used. This is known as a temporary PPM (TPPM) approach, which carries a very low risk of lead dislodgement and allows patients to ambulate, among other advantages. Here, we performed a review of the literature on the use of TPPMs and their advantages over temporary pacemakers with passive fixation leads and in order to evaluate the advantages and disadvantages of active and passive fixation leads in temporary cardiac pacing. Most articles found were case reports and case series, with few prospective studies. We excluded documents such as editorials and image case reports that provided little to no useful information for the final analysis. The literature search was performed in PubMed, Google Scholar, and other databases and articles written in English and Spanish were considered. Articles were screened up to January 2017. The search keywords used were "temporary permanent pacemaker," "external permanent pacemaker," "active fixation lead," "explantable pacemaker," "hybrid pacing," "temporary permanent generator," "prolonged temporary transvenous pacing," and "semipermanent pacemaker." A total of 24 studies with 770 patients were ultimately included in our review. The age group was primarily above the sixth decade of life, with the exception of one that included pediatric patients. Indications for pacing included device infection, sick sinus syndrome, atrioventricular block, ventricular tachycardia, and bradyarrhythmias associated with systemic illness. The duration of TPPM usage varied from a few days up to 336 days. A total of 18 (2.3%) TPPM-related infections were reported, in which the duration of TPPM use was less than 30 days in at least 15 patients. Loss of capture was documented in only eight patients (1.0%). Complication rates varied from 0% to 30%, with the highest event rates being present in studies that used femoral venous access. In conclusion, although no high-quality studies were identified in our literature search, we found the data retrieved suggest the association of overall favorable outcomes with the use of TPPMs. Device placement and removal typically involve a simple procedure, although fluoroscopy, usually applied in the cardiac catheterization laboratory, is necessary for implantation, which could represent an additional risk in a patient who is already hemodynamically unstable. When possible, a screw-in-lead pacemaker should be used for temporary pacing.
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Affiliation(s)
- Keith Suarez
- Section of Electrophysiology & Pacing, Division of Cardiology, Department of Medicine, Baylor Scott & White Temple Memorial Hospital, Baylor Scott & White Health, Dallas, TX, USA
| | - Javier E Banchs
- Section of Electrophysiology & Pacing, Division of Cardiology, Department of Medicine, Baylor Scott & White Temple Memorial Hospital, Baylor Scott & White Health, Dallas, TX, USA
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Dadalti MTDS, da Cunha AJLA, Araújo MCPD, Moraes LGBD, Risso PDA. Electromagnetic interference of dental equipment with implantable cardioverter defibrillators. Acta Odontol Scand 2017; 75:584-587. [PMID: 28799814 DOI: 10.1080/00016357.2017.1364419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Implantable cardioverter defibrillators (ICDs) are subject to electromagnetic interference (EMI). The aim of this study was to assess both the EMI of dental equipments with ICDs and related factors. MATERIALS AND METHODS High- and low-speed handpieces, an electric toothbrush, an implant motor and two types of ultrasonic devices were tested next to an ICD with different sensitivity settings. The ICD was immersed in a saline solution with electrical resistance of 400-800 ohms to simulate the resistance of the human body. The dental equipments were tested in both horizontal (0°) and vertical (90°) positions in relation to the components of the ICD. The tests were performed with a container containing saline solution, which was placed on a dental chair in order to assess the cumulative effect of electromagnetic fields. RESULTS The dental chair, high- and low-speed handpieces, electric toothbrush, implant motor and ultrasonic devices caused no EMI with the ICD, irrespective of the program set-up or positioning. No cumulative effect of electromagnetic fields was verified. CONCLUSIONS The results of this study suggest that the devices tested are safe for use in patients with an ICD.
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Affiliation(s)
| | | | - Marcos César Pimenta de Araújo
- a Department of Clinical Dentistry, School of Dentistry , Federal University of Rio de Janeiro , Rio de Janeiro , Brazil
| | - Luis Gustavo Belo de Moraes
- c Department of Cardiology, School of Medicine , Federal University of Rio de Janeiro , Rio de Janeiro , Brazil
| | - Patrícia de Andrade Risso
- a Department of Clinical Dentistry, School of Dentistry , Federal University of Rio de Janeiro , Rio de Janeiro , Brazil
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7
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Kang FG, Liu PJ, Liang LY, Lin YQ, Xie SL, He Y, Liang BS, Zhang HF, Chen YX, Wang JF. Effect of pocket irrigation with antimicrobial on prevention of pacemaker pocket infection: a meta-analysis. BMC Cardiovasc Disord 2017; 17:256. [PMID: 28964262 PMCID: PMC5622444 DOI: 10.1186/s12872-017-0689-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 09/19/2017] [Indexed: 12/30/2022] Open
Abstract
Background The presence of cardiac implantable electronic devices (CIEDs) pocket infection is difficult to treat, causing serious clinical outcomes, but little is known for prevention. Results from some studies suggested that pocket irrigation could reduce infection while others showed conflicting results. We pooled the effects of pocket irrigations on the prevention of pocket infection by meta-analysis methods. Method Relevant studies published before June, 2017 were retrieved mainly by the computer-based search of PubMed, Cochrane, EMBASE, Web of Science, Chinese BioMedical, Global Health and BIOSIS Previews databases. Estimations of relative ratios (RRs) and 95% confidence intervals (95% CIs) were pooled. Subgroup analyses according to potential key factors affecting the effects were conducted, which was confirmed by meta-regression. Sensitivity analysis and test for publication bias were also performed. Results We identified 10 studies providing data of 5467 patients receiving CIEDs implantations. Pooled infection rates were 1.48 and 3.49% respectively for medication and saline irrigation groups. Meta-analysis showed that medication irrigation conferred protection to pocket infection (RR = 0.44, 95% CI: 0.31-0.63). Subgroup analysis showed that antibiotics, rather than non-antibiotics (antiseptics) exerting the protection. The first and second lines antibiotics against staphylococcus aureus, which is the main pathogen for pocket infection, were both effective (RR = 0.42, 95% CI: 0.24-0.75 and RR = 0.34, 95% CI: 0.20-0.58 respectively for first line and second line therapies). Meta-regression revealed that region and class of irrigation medication completely explained the variance among studies and implied that effects of region were masked by medication types. Sensitivity analysis did not showed any significant change of the result and publication bias were not statistical significance. Conclusion Pocket irrigation with antibiotics were effective for reducing pocket infection and should be encouraged in CIEDs implantation.
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Affiliation(s)
- Feng-Guang Kang
- ShunDe Hospital of Guangzhou University of Chinese Medicine, Foshan, Guangdong, 528333, People's Republic of China
| | - Pei-Jian Liu
- ShunDe Hospital of Guangzhou University of Chinese Medicine, Foshan, Guangdong, 528333, People's Republic of China
| | - Li-Yi Liang
- ShunDe Hospital of Guangzhou University of Chinese Medicine, Foshan, Guangdong, 528333, People's Republic of China
| | - Yong-Qing Lin
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, People's Republic of China.,Laboratory of Cardiac Electrophysiology and Arrhythmia in Guangdong Province, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Shuang-Lun Xie
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, People's Republic of China.,Laboratory of Cardiac Electrophysiology and Arrhythmia in Guangdong Province, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Yi He
- ShunDe Hospital of Guangzhou University of Chinese Medicine, Foshan, Guangdong, 528333, People's Republic of China
| | - Bao-Shan Liang
- ShunDe Hospital of Guangzhou University of Chinese Medicine, Foshan, Guangdong, 528333, People's Republic of China
| | - Hai-Feng Zhang
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, People's Republic of China. .,Laboratory of Cardiac Electrophysiology and Arrhythmia in Guangdong Province, Guangzhou, Guangdong, 510120, People's Republic of China.
| | - Yang-Xin Chen
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, People's Republic of China. .,Laboratory of Cardiac Electrophysiology and Arrhythmia in Guangdong Province, Guangzhou, Guangdong, 510120, People's Republic of China.
| | - Jing-Feng Wang
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, People's Republic of China. .,Laboratory of Cardiac Electrophysiology and Arrhythmia in Guangdong Province, Guangzhou, Guangdong, 510120, People's Republic of China.
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Cotti E, Arrica M, Di Lenarda A, Serri SB, Bassareo P, Padeletti L, Mercuro G. The perioperative dental screening and management of patients undergoing cardiothoracic, vascular surgery and other cardiovascular invasive procedures: A systematic review. Eur J Prev Cardiol 2017; 24:409-425. [DOI: 10.1177/2047487316682348] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Elisabetta Cotti
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Italy
| | - Mariantonietta Arrica
- Department of Surgery, Microsurgery and Medical Sciences, University of Sassari, Sassari, Italy
| | - Andrea Di Lenarda
- Cardiovascular Centre of Trieste, University of Trieste, Trieste, Italy
| | - Sara B Serri
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Italy
| | | | - Luigi Padeletti
- Department of Cardiology, University of Florence, Florence, Italy
| | - Giuseppe Mercuro
- Department of Cardiology, University of Cagliari, Cagliari, Italy
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Construction of a fucoidan/laminin functional multilayer to direction vascular cell fate and promotion hemocompatibility. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 64:236-242. [DOI: 10.1016/j.msec.2016.03.070] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Revised: 01/19/2016] [Accepted: 03/21/2016] [Indexed: 12/20/2022]
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10
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Shah AH, Khalil HS, Kola MZ. Dental management of a patient fitted with subcutaneous Implantable Cardioverter Defibrillator device and concomitant warfarin treatment. Saudi Dent J 2015; 27:165-70. [PMID: 26236132 PMCID: PMC4501466 DOI: 10.1016/j.sdentj.2014.11.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 10/18/2014] [Accepted: 11/19/2014] [Indexed: 11/16/2022] Open
Abstract
Automated Implantable Cardioverter Defibrillators (AICD), simply known as an Implantable Cardioverter Defibrillator (ICD), has been used in patients for more than 30 years. An Implantable Cardioverter Defibrillator (ICD) is a small battery-powered electrical impulse generator that is implanted in patients who are at a risk of sudden cardiac death due to ventricular fibrillation, ventricular tachycardia or any such related event. Typically, patients with these types of occurrences are on anticoagulant therapy. The desired International Normalized Ratio (INR) for these patients is in the range of 2–3 to prevent any subsequent cardiac event. These patients possess a challenge to the dentist in many ways, especially during oral surgical procedures, and these challenges include risk of sudden death, control of post-operative bleeding and pain. This article presents the dental management of a 60 year-old person with an ICD and concomitant anticoagulant therapy. The patient was on multiple medications and was treated for a grossly neglected mouth with multiple carious root stumps. This case report outlines the important issues in managing patients fitted with an ICD device and at a risk of sudden cardiac death.
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Affiliation(s)
- Altaf Hussain Shah
- Department of Preventive Dental Sciences, Salman bin Abdulaziz University, AlKharj, Saudi Arabia
| | - Hesham Saleh Khalil
- Department of Maxillofacial Surgery, College of Dentistry, King Saud University, Saudi Arabia
| | - Mohammed Zaheer Kola
- Department of Prosthodontic Dental Sciences, College of Dentistry, Salman bin Abdulaziz University, AlKharj, Saudi Arabia
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Khashab MA, Chithadi KV, Acosta RD, Bruining DH, Chandrasekhara V, Eloubeidi MA, Fanelli RD, Faulx AL, Fonkalsrud L, Lightdale JR, Muthusamy VR, Pasha SF, Saltzman JR, Shaukat A, Wang A, Cash BD. Antibiotic prophylaxis for GI endoscopy. Gastrointest Endosc 2015; 81:81-9. [PMID: 25442089 DOI: 10.1016/j.gie.2014.08.008] [Citation(s) in RCA: 210] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 08/07/2014] [Indexed: 02/08/2023]
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Phulambrikar T, Kode M, Shrivastava M, Magar S, Singh SK, Gupta A, Johar N. Takayasu's arteritis--report of a case with masquerading jaw pain. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:16-21. [PMID: 24908595 DOI: 10.1016/j.oooo.2014.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Revised: 02/26/2014] [Accepted: 03/09/2014] [Indexed: 10/25/2022]
Abstract
Takayasu's arteritis (TA) often referred to as pulseless disease, is a chronic inflammatory disorder affecting the aorta and its main branches. While the first reported case was documented in Japan in 1908, it does occur worldwide, but is more prevalent in young oriental females from China and Southeast Asia. The main complications of the disease are due to occlusion of major branches of the aorta. During the initial stages, one of the presenting symptoms may be jaw pain. This may prove to be a diagnostic challenge for the dentist, since many diseases cause orofacial pain and the diagnosis must be established before final treatment. A literature review of TA is presented along with clinical presentation and treatment modalities. A case report is also presented.
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Affiliation(s)
- Tushar Phulambrikar
- Oral Medicine Diagnosis and Radiology, Sri Aurobindo College of Dentistry, Indore, India
| | - Manasi Kode
- Oral Medicine Diagnosis and Radiology, Sri Aurobindo College of Dentistry, Indore, India
| | - Mayank Shrivastava
- Oral Medicine Diagnosis and Radiology, Sri Aurobindo College of Dentistry, Indore, India.
| | - Shaliputra Magar
- Oral Medicine Diagnosis and Radiology, Sri Aurobindo College of Dentistry, Indore, India
| | - Siddharth Kumar Singh
- Oral Medicine Diagnosis and Radiology, Sri Aurobindo College of Dentistry, Indore, India
| | - Anjali Gupta
- Oral Medicine Diagnosis and Radiology, Sri Aurobindo College of Dentistry, Indore, India
| | - Navdeep Johar
- Oral Medicine Diagnosis and Radiology, Sri Aurobindo College of Dentistry, Indore, India
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13
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Severe staphylococcal sepsis in patient with permanent pacemaker. Int J Cardiol 2014; 172:e498-501. [DOI: 10.1016/j.ijcard.2014.01.048] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 01/10/2014] [Indexed: 11/19/2022]
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14
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Karim S, Hussein A, Batal O, Karim MM, Tarakji K, Saliba W, Martin D, Wazni O, Kanj M, Wilkoff BL, Callahan T. Outcomes after endocarditis or device infection in patients with left ventricular epicardial leads versus coronary sinus leads. J Interv Card Electrophysiol 2014; 39:267-71. [DOI: 10.1007/s10840-014-9880-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Accepted: 01/28/2014] [Indexed: 12/01/2022]
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15
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Tanawuttiwat T, Garisto JD, Salow A, Glad JM, Szymkiewicz S, Saltzman HE, Kutalek SP, Carrillo RG. Protection from outpatient sudden cardiac death following ICD removal using a wearable cardioverter defibrillator. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2013; 37:562-8. [PMID: 24762055 DOI: 10.1111/pace.12319] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 10/07/2013] [Accepted: 10/13/2013] [Indexed: 12/19/2022]
Abstract
BACKGROUND An implantable cardioverter defibrillator (ICD) is effective in preventing sudden cardiac death (SCD). Once an ICD is removed and reimplantation is not feasible, a wearable cardioverter defibrillator (WCD) may be an alternative option. We determined the effectiveness of WCD for SCD prevention in patients who were discharged after ICD removal. METHODS A retrospective study was conducted on all WCD (LifeVest, ZOLL, Pittsburgh, PA, USA) patients who underwent ICD removal due to cardiac device infections (CDIs) at two referral centers between January 1, 2005 and December 31, 2009. Clinical characteristics, device information, and WCD data were analyzed. Sudden cardiac arrest was defined as all sustained ventricular tachycardia (VT) and ventricular fibrillation occurring within a single 24-hour period. RESULTS Ninety-seven patients (mean age 62.8 ± 13.3, male 80.4%) were included in the study. The median duration of antibiotic use was 14.7 days (interquartile range [IQR] 10-30). The median daily WCD use was 20 hours/day and the median length of use was 21 days (IQR 5-47). A total of three patients were shocked by WCD. Two patients had four episodes of sustained VT, successfully terminated by the WCD. A third patient experienced two inappropriate treatments due to oversensitivity of the signal artifact. Three patients experienced sudden death outside the hospital while not wearing the device. Five patients died while hospitalized. CONCLUSION WCD can prevent SCD, until ICD reimplantation is feasible in patients who underwent device removals for CDI. However, patient compliance is essential for the effective use of this device.
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Affiliation(s)
- Tanyanan Tanawuttiwat
- Division of Cardiovascular Disease, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida
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