心脏植入式电子设备(CIED)感染是与设备植入相关的最具威胁性的并发症之一。由于发病率和死亡率的增加,以及医疗费用。此外,重要的是要强调,与最初植入设备相比,与诸如发电机更换之类的程序相关的风险,铅和口袋修订,或设备升级双。因此,为了解决这个问题,各种评分系统,像PADIT(事先程序,年龄,肾功能下降,免疫受损状态,程序类型),RI-AIAC(RicercaSulleInfezioniAssociateaImpiAntooSostitutzionediCIED),还有Shariff得分,以及预测模型,已开发用于识别感染风险更大的患者。此外,已经评估了几种干预措施以评估其在感染预防中的作用,从改善皮肤准备和手术技术到考虑替代策略,例如皮下植入式心脏复律除颤器(ICD)。预防抗菌药物等方法,口袋灌溉,葡萄糖酸氯己定口袋灌洗,囊切除术,还探索了使用抗菌信封作为预防措施。在这次审查中,我们提供了对重复手术患者的CIED感染的全面评估,以及旨在降低这些感染风险的策略.
Cardiac implantable electronic device (CIED) infections represent one of the most threatening complications associated with device implantation, due to an increase in morbidity and mortality rates, as well as healthcare costs. Besides, it is important to highlight that when compared to the initial implantation of a device, the risks associated with procedures like generator changes, lead and pocket revisions, or device upgrades double. Consequently, to address this issue, various scoring systems, like the PADIT (Prior Procedures, Age, Depressed Renal Function, Immunocompromised Status, Type of Procedure), the RI-AIAC (Ricerca Sulle Infezioni Associate a ImpiAnto o Sostituzione di CIED), and the Shariff score, along with predictive models, have been developed to identify patients at a greater risk of infection. Moreover, several interventions have been assessed to evaluate their role in infection prevention ranging from improving skin preparation and surgical techniques to considering alternative strategies such as the subcutaneous Implantable Cardioverter-Defibrillator (ICD). Methods like antimicrobial prophylaxis, pocket irrigation, chlorhexidine gluconate pocket lavage, capsulectomy, and the use of antibacterial envelopes have been also explored as preventive measures. In this review, we provide a comprehensive assessment of CIED infections in patients undergoing repeat procedures and the strategies designed to reduce the risk of these infections.