[Infection of ICD: prevention and therapy].
Infections of implantable cardioverter defibrillators (ICD) are severe, potentially life-threatening complications of ICD therapy. In the majority these infections are nosocomial by staphylococci, which become apparent within 0.5 years after implantation. Prophylaxis requires a strictly sterile environment during implantation and perioperative antibiotics. While infection of the ICD pocket is diagnosed clinically, infection of the electrodes must be proven by transesophageal echocardiography and positive blood cultures. Therapeutically, the complete ICD system has to be removed to avoid relapses of infection. Beyond 6 months after implantation, lead extraction might become technically demanding and should be done with a standby of cardiac surgery. Antibiotic treatment has to be started before removal of the system, continued for at least 2 weeks before reimplantation and for another 10 days thereafter. Reimplantation should be done outside the originally infected area.
Block
Michael
M
Kardiologie, Stiftsklinik Augustinum, München. block@med.augustinum.de
Adler
Kai
K
Brömsen
Jürgen
J
D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control*; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D004567:Electrodes, Implanted / Q000009:adverse effects; D004866:Equipment Contamination / Q000517:prevention & control*; D006801:Humans; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000517:prevention & control*; D013242:Sterilization / Q000379:methods
D000900:Anti-Bacterial Agents