Weiss R, Mark GE, El-Chami MF, Biffi M, Probst V, Lambiase PD, Miller MA, McClernon T, Hansen LK, Knight BP, Baddour LM. Process Mapping Strategies to Prevent Subcutaneous Implantable Cardioverter-Defibrillator Infections.
J Cardiovasc Electrophysiol 2022;
33:1628-1635. [PMID:
35662315 PMCID:
PMC9544305 DOI:
10.1111/jce.15566]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 05/02/2022] [Accepted: 05/26/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND
Infection remains a major complication of cardiac implantable electronic devices (CIEDs) and can lead to significant morbidity and mortality. Implantable devices that avoid transvenous leads, such as the subcutaneous implantable cardioverter-defibrillator (S-ICD), can reduce the risk of serious infection-related complications, such as bloodstream infection and infective endocarditis. While the 2017 AHA/ACC/HRS guidelines include recommendations for S-ICD use for patients at high risk of infection, currently, there are no clinical trial data that address best practices for the prevention of S-ICD infections. Therefore, an expert panel was convened to develop consensus on these topics.
METHODS
An expert process mapping methodology was used to achieve consensus on the appropriate steps to minimize or prevent S-ICD infections. Two face-to-face meetings of high-volume S-ICD implanters and an infectious diseases specialist, with expertise on cardiovascular implantable electronic device infections, were conducted to develop consensus on useful strategies pre-, peri-, and post-implant to reduce S-ICD infection risk.
RESULTS
Expert panel consensus of recommended steps for patient preparation, S-ICD implantation, and post-operative management were developed to provide guidance in individual patient management.
CONCLUSION
Achieving expert panel consensus by process mapping methodology for S-ICD infection prevention was attainable, and the results should be helpful to clinicians in adopting interventions to minimize risks of S-ICD infection. This article is protected by copyright. All rights reserved.
Collapse