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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Saturday, May 4, 2013

Infección del marcapasos

Johansen J et al. European Heart Journal 2011 - doi:10.1093/eurheartj/ehq497

"Infection is a serious complication of pacemaker (PM) systems. Although the rate of infection has been debated, the figures are largely unknown. We therefore studied the incidence of PM infection and its associated risk factors in the Danish population."
Dababneh A & Sohail M. Cleveland Clinic Journal of Medicine 2011; 78(8): 529-537

  • "Although inflammatory signs at the generator pocket are the most common presentation of an infection occurring soon after the device is implanted, positive blood cultures may be the sole manifestation of a late-onset endovascular  infection.
  • Staphylococci are the most common pathogens in both pocket infections and endovascular infections.
  • Two sets of blood cultures should be obtained in all patients suspected of having a cardiac device infection.
  • Transesophageal echocardiography should be ordered in all patients with suspected cardiac device infection who have positive blood cultures, as it can identify intracardiac complications of infection"
and Their Management.
A Scientific Statement From the American Heart Association
Baddour L et al. Circulation 2010; 121: 458-477

"Despite improvements in cardiovascular implantable electronic device (CIED) design, application of timely infection control practices, and administration of antibiotic prophylaxis at the time of device placement, CIED infections continue to occur and can be life-threatening. This has prompted the study of all aspects of CIED infections. Recognizing the recent advances in our understanding of the epidemiology, risk factors, microbiology, management, and prevention of CIED infections, the American Heart Association commissioned this scientific statement to educate clinicians about CIED infections, provide explicit recommendations for the care of patients with suspected or established CIED infections, and highlight areas of needed research."