0
Summaries for Patients |

Infections Involving Implantable Cardiac Devices FREE

[+] Article and Author Information

Copyright ©2004 by the American College of Physicians


Ann Intern Med. 2000;133(8):I-51. doi:10.7326/0003-4819-133-8-200010170-00006
Text Size: A A A

What is the problem and what is known about it so far?

Implantable cardiac devices are electronic instruments placed under the skin, from which wires (called “leads”) go into the heart. These devices include pacemakers and cardioverter defibrillators, which are used to treat abnormal heart rhythms. Implantable cardiac devices, like any device that is placed in the body, can become infected. Infections involving implanted devices usually do not get better unless the device is removed. Removing the leads for pacemakers and cardioverter defibrillators can create problems, however, so the best approach to treatment when those devices become infected is not known.

Why did the researchers do this particular study?

To describe the medical histories of a relatively large group of patients with implantable cardiac devices that became infected.

Who was studied?

The study included 123 patients with infections of implantable cardiac devices (87 pacemakers and 36 cardioverter defibrillators) who were referred to the Cleveland Clinic, a large teaching hospital.

How was the study done?

The researchers examined the patients and collected information about their symptoms, medical history, and treatment from the patients and their medical records.

What did the researchers find?

Most patients' initial signs of infection were pain, redness, and oozing of the skin over the device. One quarter of the infections occurred within 28 days after the device was implanted, one third occurred within 29 to 364 days, and the rest occurred after 365 days or more. The cardiac devices, including the leads, were completely removed in 117 of the 123 patients. Those patients were then treated with antibiotics for an average of 28 days, as were the patients whose devices were not removed. A new device was placed in 86 of the 117 patients who had had the infected device removed, about 1 week after removal of the first device. The infection relapsed (occurred again) in only 4 patients out of the entire group of 123 patients: 3 of the 6 who did not have the device removed completely and 1 of the 117 who did.

What were the limitations of the study?

This study simply describes what happened to patients cared for at a single medical center. It is not known whether similar results are found at other centers. The researchers did not compare different strategies of treatment, so they cannot say for sure that complete removal of the device followed by antibiotic therapy is the best way to treat these infections.

What are the implications of the study?

Patients whose implantable cardiac devices have become infected generally seem to do well when the device is removed and they are given a course of antibiotics.

Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.

Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician.

The summary below is from the full report titled “Diagnosis and Management of Infections Involving Implantable Electrophysiologic Cardiac Devices.” It is in the 17 October 2000 issue of Annals of Internal Medicine (volume 133, pages 604-608). The authors are JD Chua, BL Wilkoff, I Lee, N Juratli, DL Longworth, and SM Gordon.

Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.

Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician.

The summary below is from the full report titled “Diagnosis and Management of Infections Involving Implantable Electrophysiologic Cardiac Devices.” It is in the 17 October 2000 issue of Annals of Internal Medicine (volume 133, pages 604-608). The authors are JD Chua, BL Wilkoff, I Lee, N Juratli, DL Longworth, and SM Gordon.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Related Point of Care
Topic Collections
PubMed Articles

Want to Subscribe?

Learn more about subscription options

Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)