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Process mapping strategies to prevent subcutaneous implantable cardioverter-defibrillator infections

Weiss, Raul; Mark, George E; El-Chami, Mikhael F; Biffi, Mauro; Probst, Vincent; Lambiase, Pier D; Miller, Marc A; ... Baddour, Larry M; + view all (2022) Process mapping strategies to prevent subcutaneous implantable cardioverter-defibrillator infections. Journal of Cardiovascular Electrophysiology , 33 (7) pp. 1628-1635. 10.1111/jce.15566. Green open access

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Abstract

Background: Infection remains a major complication of cardiac implantable electronic devices and can lead to significant morbidity and mortality. Implantable devices that avoid transvenous leads, such as the subcutaneous implantable cardioverter-defibrillator (S-ICD), can reduce the risk of serious infection-related complications, such as bloodstream infection and infective endocarditis. While the 2017 AHA/ACC/HRS guidelines include recommendations for S-ICD use for patients at high risk of infection, currently, there are no clinical trial data that address best practices for the prevention of S-ICD infections. Therefore, an expert panel was convened to develop a consensus on these topics. Methods: An expert process mapping methodology was used to achieve consensus on the appropriate steps to minimize or prevent S-ICD infections. Two face-to-face meetings of high-volume S-ICD implanters and an infectious diseases specialist, with expertise in cardiovascular implantable electronic device infections, were conducted to develop consensus on useful strategies pre-, peri-, and postimplant to reduce S-ICD infection risk. Results: Expert panel consensus on recommended steps for patient preparation, S-ICD implantation, and postoperative management was developed to provide guidance in individual patient management. Conclusion: Achieving expert panel consensus by process mapping methodology for S-ICD infection prevention was attainable, and the results should be helpful to clinicians in adopting interventions to minimize risks of S-ICD infection.

Type: Article
Title: Process mapping strategies to prevent subcutaneous implantable cardioverter-defibrillator infections
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/jce.15566
Publisher version: https://doi.org/10.1111/jce.15566
Language: English
Additional information: © 2022 The Authors. Journal of Cardiovascular Electrophysiology published by Wiley Periodicals LLC. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
Keywords: Science & Technology, Life Sciences & Biomedicine, Cardiac & Cardiovascular Systems, Cardiovascular System & Cardiology, antibiotic prophylaxis, antibiotics, defibrillator, infection, mapping, prevention, subcutaneous implantable cardioverter-defibrillator, surgical site infection, 2-INCISION TECHNIQUE, DEVICE INFECTION, EFFICACY, MANAGEMENT, OUTCOMES, SURGERY, SAFETY
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Clinical Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10152448
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