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Infection incidence for pacemaker implants increased from 1993 to 2008

Issue: June 2011

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Heart Rhythm Society 32nd Annual Scientific Sessions

SAN FRANCISCO — The burden of infection among recipients of cardiac implantable electronic devices has increased between 1993 and 2008 for pacemakers, but not for implantable cardioverter defibrillators, according to new research.

Researchers for the study reviewed data from the National Inpatient Sample to identify patients receiving pacemakers and ICD between 1993 and 2008. They used ICD-9-CM procedure codes to identify the specific patients, including the codes for primary pacemaker, primary ICD, pacemaker removal and ICD removal. Patient comorbidities and the national incidence for pacemakers and ICDs were evaluated.

A total of 3.2 million patients received pacemakers and 1.1 million received ICDs from 1993 to 2008, and a total of 73,000 of them were diagnosed with infection (1.88% for pacemakers and 1.13% for ICDs). A 224% increase in the infection rate was reported in pacemaker patients from 1993 (1.6%) to 2008 (3.5%), while ICD infection rates remained constant over time. The incidence of infection was also 75% higher in patients with pacemakers vs. those with ICDs (P<.001). The incidence in infection rose in ICD patients with HF (OR=1.28), renal failure (OR=2.18) and respiratory failure (OR=1.30), while pacemaker infection rose in patients with diabetes (OR=1.12), HF (OR=1.46), renal failure (OR=2.38) and respiratory failure (OR=2.25).

The researchers also noted that in 2008, over 32% of patients with infected ICDs or pacemakers were diagnosed with renal failure, which was an increase from 1993.

“The dimensions of the national cardiac implantable electronic device infection burden are changing due to the increasing prevalence of comorbidities, particularly renal failure,” the researchers concluded in their abstract. “Strategies for decreasing cardiac implantable electronic device infection should include a better understanding of periprocedural risk factors.”

For more information:

• Patel J. Abstract AB 21-1. Presented at: Heart Rhythm Society 32nd Annual Scientific Sessions; May 4-7, 2011; San Francisco.

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