Author + information
- Scott Koerber,
- Mohit Turagam,
- Jeffrey Winterfield and
- Michael Gold
Cardiac implantable electronic device (CIED) infection rates have continued to increase and are associated with increased hospitalizations and mortality. A number of preventative strategies have been developed including an antibiotic coated envelope, but this approach has yet to gain widespread use.
To evaluate the efficacy of the antibiotic envelope for infection reduction after CIED implantation, a meta-analysis was performed on controlled studies of the antibiotic envelop. PubMed and Google Scholar were searched for studies comparing infection rates with and without the use of an antibiotic envelope. Studies including both new implants and pulse generator replacements were included in the analysis.
Six studies were included in the analysis. A total of 5,036 patients underwent CIED implantation, 1,705 with an antibiotic envelope and 3,331 without an envelope. In the pooled cohort, the envelope was associated with a 67% relative risk reduction in CIED infection (0.33[0.18,0.61]CI 95%, p=0.004). Propensity matched data from 4 studies were analyzed to ensure accurate comparison (Fig. 1). In this risk matched cohort, infections were significantly lower in the envelope group (4 vs 31, p< 0.0001). A low degree of heterogeneity was demonstrated by a Cochran I-q statistic (I2=0).
The use of antibiotic envelopes in CIED placement was associated with a significantly lower rate of infection.
Poster Hall, Hall A/B
Saturday, March 10, 2018, 3:45 p.m.-4:30 p.m.
Session Title: Extraction, Infection and Lead Complications
Abstract Category: 05. Arrhythmias and Clinical EP: Devices
Presentation Number: 1142-002
- 2018 American College of Cardiology Foundation