期刊
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY
卷 36, 期 3, 页码 354-361出版社
WILEY-BLACKWELL
DOI: 10.1111/pace.12063
关键词
CRT; new technology; pacing
资金
- Boehringer-Ingelheim Pharmaceuticals
- TyRX Inc.
Introduction The incidence of cardiac implantable electronic device (CIED) infections has risen rapidly since 2004. A commercially available minocycline and rifampin impregnated antibacterial envelope has been associated with a low CIED infection rate. We performed a retrospective cohort study analyzing CIED infection rates in patients receiving an antibacterial envelope. Methods Prospectively applied criteria for use of the antibacterial envelope included 2 of the following: diabetes, renal insufficiency, anticoagulation, chronic corticosteroid use, fever or leukocytosis at the time of implantation, prior CIED infection, 3 leads (cardiac resynchronization therapy or abandoned leads), pacemaker dependence, or early pocket reentry. CIED infection rate was compared to a cohort of patients with matched risk factors and a CIED implanted prior to use of the antibacterial envelope. Results A total of 260 antibacterial envelopes were implanted from November 1, 2009 to April 30, 2012. The mean number of CIED infection risk factors was 2.8 +/- 1.2. The control cohort (N = 639) was matched for mean number of CIED infection risk factors (2.8 +/- 1.2), though individual risk factors differed. After a minimum of 90 days of follow-up, there was one CIED infection among patients who received an antibacterial envelope (0.4%), compared to 19 (3%) in controls (odds ratio [95% confidence interval] 0.13 [0.020.95], P = 0.04). This difference persisted after adjustment for covariates (0.09 [0.010.73], P = 0.02) and propensity score matching (0.11 [0.010.85], P = 0.04). Conclusions In patients prospectively identified at high risk for CIED infection, use of a commercially available antibacterial envelope was associated with a marked reduction in CIED infections when compared to a matched control cohort. (PACE 2013; 36:354-361)
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