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Muhammad R Sohail - One of the best experts on this subject based on the ideXlab platform.

Axel Haverich - One of the best experts on this subject based on the ideXlab platform.

  • complete removal as a routine treatment for any cardiovascular implantable Electronic Device associated infection
    The Journal of Thoracic and Cardiovascular Surgery, 2011
    Co-Authors: Maximilian Pichlmaier, Ludmilla Knigina, Ingo Kutschka, Christoph Bara, Hanno Oswald, Gunnar Klein, Theodosius Bisdas, Axel Haverich
    Abstract:

    Objective Pacemaker and implantable cardioverter defibrillator lead endocarditis mandates removal of all foreign material. In supposedly limited (pocket) infections, such a radical approach is still controversial. Thus, some patients are potentially exposed to persistent and recurrent infection because of retained material. Procedural risks and the success of eradicating infection were examined if involvement of the complete system was assumed in any cardiovascular implantable Electronic Device infection and complete removal was thus mandatory. Methods A 12-year experience with 192 consecutive cases of bacterial pacemaker (152) or defibrillator (40) infections is presented. Complete removal of all prosthetic material was always aimed for. This was followed by antibiotic treatment for 4 to 6 weeks under temporary pacing if required, and then the new system was implanted. A total of 104 parameters concerning patient characteristics and operative and postoperative treatment were examined for their influence on outcome. Results Infection was eradicated in 92.8% of patients. Recurrence was predominantly caused by failure to remove all prosthetic material (P  Conclusions Complete removal of prosthetic material in any cardiovascular implantable Electronic Device infection is safe and associated with low morbidity and mortality. Success of eradicating infection is high if all system components are removed. Temporary pacing in dependent patients may be performed safely on an outpatient basis.

M. Rizwan Sohail - One of the best experts on this subject based on the ideXlab platform.

  • Approach to Diagnosis of Cardiovascular Implantable-Electronic-Device Infection.
    Journal of Clinical Microbiology, 2018
    Co-Authors: Daniel C Desimone, M. Rizwan Sohail
    Abstract:

    Device infection remains a significant challenge as clinical indications for cardiovascular implantable Electronic Device (CIED) therapy continue to expand beyond the prevention and treatment of cardiac arrhythmias. Patients receiving CIED therapy are now older and have significant comorbidities, placing them at higher risk of complications, including infection. CIED infection warrants complete Device removal, as retention is associated with an unacceptably high risk of relapse and increased mortality. However, accurate diagnosis of CIED infections remains a significant challenge that is based on a combination of findings on physical examination, microbiological and laboratory testing, and advanced imaging, such as transesophageal echocardiography or positron emission tomography. Isolating a causative pathogen and performing susceptibility testing are crucial for appropriate choice, route, and duration of antimicrobial therapy. In this review, we present an evidence-based approach to diagnosis of CIED infection.

Arnold J Greenspon - One of the best experts on this subject based on the ideXlab platform.

Larry M Baddour - One of the best experts on this subject based on the ideXlab platform.