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Postimplantation pocket hematoma increases risk of cardiac implantable electronic device infection: A meta-analysis

Jakrin Kewcharoen1, Chanavuth Kanitsoraphan1, Sittinun Thangjui2

  • 1University of Hawaii Internal Medicine Residency Program Honolulu HI USA.

Journal of Arrhythmia
|June 18, 2021
PubMed

Insights

Postimplantation pocket hematoma significantly elevates the risk of cardiac implantable electronic device (CIED) infection. Careful device implantation can help prevent hematoma and subsequent CIED infections.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Device Technology

Background:

  • The relationship between postimplantation pocket hematoma and cardiac implantable electronic device (CIED) infection remains inconsistent in existing literature.
  • Hematomas occurring after device implantation are a potential concern for infection development.

Purpose of the Study:

  • To systematically review and perform a meta-analysis to clarify the effect of postimplantation hematoma on the risk of CIED infection.

Main Methods:

  • A comprehensive search of MEDLINE and EMBASE databases was conducted up to March 2020.
  • Included studies encompassed cohort, case-control, cross-sectional, and randomized controlled trials reporting on hematoma and CIED infection incidence.
  • Data were synthesized using a random-effects model to calculate odds ratios (OR) and 95% confidence intervals (CI).

Main Results:

  • The analysis included 14 studies with 28,319 participants.
  • Postimplantation pocket hematoma was found to significantly increase the risk of overall CIED infection (OR = 6.30, 95% CI: 3.87-10.24).
  • No significant publication bias or small-study effect was detected.

Conclusions:

  • This meta-analysis confirms that postimplantation pocket hematoma is a significant risk factor for CIED infection.
  • Implementing precautions during device implantation to minimize hematoma formation is crucial for preventing subsequent infections.
Abstract

Keywords:
cardiac implantable electronic devicecardiac implantable electronic device infectionhematoma

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