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Absorbable antibacterial envelope eliminates additional expected cardiac implantable electronic device infections in high-risk patients
Session:
SESSÃO DE POSTERS 45 - DISPOSITIVOS CARDÍACOS IMPLANTÁVEIS: COMPLICAÇÕES E SUA PREVENÇÃO
Speaker:
António Baptista Carvalho
Congress:
CPC 2025
Topic:
C. Arrhythmias and Device Therapy
Theme:
09. Device Therapy
Subtheme:
09.5 Device Complications and Lead Extraction
Session Type:
Cartazes
FP Number:
---
Authors:
António Baptista Carvalho; Marina Santos; Sofia Jacinto; Hélder Santos; Guilherme Portugal; Ana Lousinha; Pedro Silva Cunha; Bruno Valente; Paulo Osório; Mário Oliveira
Abstract
<p>Background: Cardiac implantable electronic device (CIED) infections are associated with significant morbidity and mortality, necessitating prolonged hospitalization and often requiring device extraction. While the overall CIED infection rate is approximately 2%, this figure escalates to 4% in high-risk populations. Absorbable antibacterial envelopes (AAEs) have emerged as a promising prophylactic strategy to mitigate infection risk.<br /> <br /> Purpose: This study sought to evaluate the impact of AAE utilization on CIED infection rates within a high-risk patient cohort.<br /> <br /> Methods: This observational, longitudinal study, conducted over a 5-year, enrolled 106 patients undergoing CIED implantation with concomitant AAE placement. Patient evaluation occurred at 12 months and at study conclusion. AAE utilization was guided by established risk stratification tools (Mittal, Shariff, and PADIT scores) in conjunction with physician clinical judgment. Patients were dichotomized into low-risk and intermediate-high-risk groups, with the latter defined as PADIT >6, Shariff >2, or Mittal >7.<br /> <br /> Results: The study cohort comprised 106 patients (69.8% male; mean age 70±15 years) receiving pacemakers (39.6%), cardiac resynchronization therapy devices (CRT, 38.7%), or implantable cardioverter-defibrillators (ICD, 21.7%). Prevalent comorbidities included diabetes (26.2%), systemic hypertension (74.2%), chronic kidney dysfunction (68.6%), and heart failure (75%). Notably, 65.1% of participants underwent CIED implantation in the setting of device revision, upgrade, or reimplantation following infection-related extraction. Median risk scores were as follows: PADIT 7 (IQR 2), Shariff 3 (IQR 2), and Mittal 11 (IQR 10). The majority of patients (73%) were classified as intermediate-high risk. During the follow-up period, 3 CIED infections (2.9%) were observed, with 2 cases occurring within the intermediate-high-risk group. No statistically significant association was identified between risk group and infection incidence at 12 months (p=0.633).<br /> <br /> Conclusion: In this cohort characterized by a high prevalence of intermediate-to-high-risk individuals, AAE utilization was associated with a low incidence of CIED infection. Furthermore, AAE implementation appears to diminish the predictive validity of established risk stratification tools, yielding comparable infection rates across low- and high-risk strata.</p>
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