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Infection after ICD implantation: operating room versus cardiac catheterisation laboratory

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Abstract

Background/ObjectivesSince the insertion of an implantable cardioverter-defibrillator (ICD) has become technically comparable to pacemaker implantation, these procedures are increasingly being performed in a cardiac catheterisation laboratory (CCL) instead of the operating room (OR). This study aims to describe the relationship between incidence of ICD infection and procedure setting and to describe the characteristics of ICD infection.

MethodsA retrospective study was performed of first ICD implantation in 677 patients admitted to our hospital between 1996 and 2006. Implantations were performed in the OR until 2003, after 2003 they were carried out in the CCL. The follow-up was censored at one year after implantation. ICD infections were defined as pocket infection or ICD-related endocarditis and a descriptive analysis was performed.

ResultsCardiothoracic surgeons implanted 366 ICDs in the OR Electrophysiologists performed 301 implantations in the CCL. Pulse generators were inserted using a pectoral approach with transvenous lead systems. We identified seven ICD infections (incidence rate 1.2/100 person-years), three of which had been implanted in the OR and four in the CCL.

ConclusionIn this single-centre study no difference in the incidence of ICD infection was observed between implantation in OR and CCL. However, a larger study will be necessary to rule out a relationship with certainty. (Neth Heart J 2009;17:95–100.)

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Correspondence to H. H. F. Remmelts.

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Department of Internal Medicine and Infectious Diseases, University Medical Centre Utrecht, Utrecht, the Netherlands

Department of Cardiology, University Medical Centre Utrecht, Utrecht, the Netherlands

Department of Cardiology, University Medical Centre Utrecht, Utrecht, the Netherlands

Department of Cardio-Thoracic Surgery, University Medical Centre Utrecht, Utrecht, the Netherlands

H.H.F. Remmelts.C/o: M. Meine, University Medical Centre Utrecht, Department of Cardiology, PO Box 85500, 3508 GA Utrecht, the Netherlands

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Remmelts, H.H.F., Meine, M., Loh, P. et al. Infection after ICD implantation: operating room versus cardiac catheterisation laboratory. NHJL 17, 95–100 (2009). https://doi.org/10.1007/BF03086226

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