Preventive infection control in cardiac device implantation

Cardiac implantable electronic devices have been increasingly used in recent years; as a result, there has been a rise in device-related complications. Pacemaker-associated infection is challenging to manage, including system removal, antimicrobial therapy and reimplantation at another site. The aim of this study was to evaluate adherence to the steps in an infection control protocol in cardiac device implantation.

A total of 100 patients referred for cardiac device implantation were enrolled in the study. They were evaluated with regard to the application of infection control measures during device implantation and followed-up for 6 months to detect clinical signs of device-related infection (DRI). A significant correlation was found between the development of postoperative DRI and the presence or absence of the following factors: increasing patient age (p = 0.010), diabetes mellitus (p = 0.024), number of operators ≥4 (p = 0.001), implantation of a biventricular system (p = 0.025), duration of sterilization (p = 0.001), wearing double gloves (p < 0.001) and postoperative hematoma (p = 0.021).

The study identified the following risk factors for DRI: age, diabetes mellitus and cardiac resynchronization therapy system implantation (p = 0.025). Antiseptic measures such as double-glove technique and duration of skin disinfection prior to the procedure, as well as environmental factors, also influenced device infection, as did the number of operators/staff and pocket hematoma.