Preventive infection control in cardiac device implantation

Area of Science:

• Cardiology
• Infectious Diseases
• Medical Device Technology

Background:

• Cardiac implantable electronic devices (CIEDs) are increasingly used, leading to a rise in device-related complications.
• Pacemaker-associated infections pose significant management challenges, often requiring device removal, antimicrobial therapy, and reimplantation.
• Evaluating adherence to infection control protocols is vital for mitigating risks associated with CIED procedures.

Purpose of the Study:

• To assess adherence to infection control protocols during cardiac device implantation procedures.
• To identify risk factors associated with device-related infections (DRI) in patients receiving CIEDs.

Main Methods:

• A prospective study involving 100 patients undergoing cardiac device implantation.
• Evaluation of infection control measure adherence during implantation.
• Follow-up for 6 months to detect clinical signs of device-related infection (DRI).

Main Results:

• Significant correlations were found between DRI development and patient age, diabetes mellitus, number of operators (≥4), biventricular system implantation, duration of sterilization, double-glove use, and postoperative hematoma.
• Factors like increasing patient age (p=0.010), diabetes mellitus (p=0.024), and biventricular system implantation (p=0.025) were significantly associated with DRI.
• Adherence to specific measures like double-gloving (p<0.001) and longer sterilization duration (p=0.001) correlated with reduced DRI.

Conclusions:

• Key risk factors for DRI include patient age, diabetes mellitus, and cardiac resynchronization therapy (CRT) system implantation.
• Antiseptic measures, such as the double-glove technique and adequate skin disinfection duration, significantly impact DRI rates.
• Environmental factors, number of operators, and occurrence of pocket hematoma also play a role in the incidence of device infections.