What question did this study set out to answer?

To provide comprehensive international consensus guidance on the risk assessment, prevention, diagnosis, and treatment of cardiac implantable electronic device (CIED) infections.

August 20, 2019EP EuropaceOpen Access

European Heart Rhythm Association (EHRA) international consensus document on how to prevent, diagnose, and treat cardiac implantable electronic device infections—endorsed by the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS), the Latin American Heart Rhythm Society (LAHRS), International Society for Cardiovascular Infectious Diseases (ISCVID) and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)

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Why the study?

Uncertainties remained regarding various preventive, diagnostic, and treatment measures for CIED infections, guidance was limited on novel device alternatives and quality requirements, and an international consensus document was lacking.

Design

International consensus document

Authors

CBCarina Blomström‐LundqvistUppsala University VTVassil TraykovElectrophysiology PEPaola Anna ErbaCollege Board

Discussion

Member takes

Implication

Supports individualized antibiotic prophylaxis for CIED procedures; leaves open need for randomized trials before practice change.

Key Points

To provide comprehensive international consensus guidance on the risk assessment, prevention, diagnosis, and treatment of cardiac implantable electronic device (CIED) infections.
Reviewed and synthesized evidence from recent randomized controlled trials evaluating device infection prevention measures, including intravenous antibiotics and antibacterial envelopes.
Evaluated worldwide clinical variation and management disparities identified through an international European Heart Rhythm Association survey.
Formulated multidisciplinary consensus recommendations covering skin preparation, procedural prophylaxis, device alternatives, operator quality requirements, and infection therapy.
Standardizes pre-procedural intravenous antibiotic prophylaxis while defining current evidence regarding skin antiseptics, antibiotic pocket irrigation, and post-operative oral antibiotics.
Provides structured clinical guidance regarding the role of novel device technologies, anticoagulation management, and minimal institutional volume standards.
Establishes a unified global framework for prompt diagnosis, microbiological identification, and definitive management of CIED-related bloodstream and pocket infections.

Structured PICO

Population

Patients receiving or living with cardiac implantable electronic devices (CIEDs)

Intervention

Strategies for risk assessment, prevention, diagnosis, and treatment of CIED infections

This international consensus document provides comprehensive guidance on the prevention, diagnosis, and management of cardiac implantable electronic device infections.

Cite This Study

Blomström‐Lundqvist et al. (2019) studied this question.

synapsesocial.com/papers/6a7cb4d1e7df423ee14c7aca https://doi.org/10.1093/europace/euz246

Topics

Cardiac device therapy

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Discussion

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Implication

Key Points

Structured PICO

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Discussion

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Implication

Key Points

Structured PICO

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