Tarakji Khaldoun G, Ellis Christopher R, Defaye Pascal, Kennergren Charles
Heart and Vascular Institute, Cleveland Clinic, Ohio, US.
Vanderbilt Heart and Vascular Institute at Vanderbilt University, Nashville, Tennessee, US.
Arrhythm Electrophysiol Rev. 2016 May;5(1):65-71. doi: 10.15420/aer.2015.27.2.
The incidence of infection following implantation of cardiac implantable electronic devices (CIEDs) is increasing at a faster rate than that of device implantation. Patients with a CIED infection usually require hospitalisation and complete device and lead removal. A significant proportion die from their infection. Transvenous lead extraction (TLE) is associated with rare but serious complications including major vascular injury or cardiac perforation. Operator experience and advances in lead extraction methods, including laser technology and rotational sheaths, have resulted in procedures having a low risk of complication and mortality. Strategies for preventing CIED infections include intravenous antibiotics and aseptic surgical techniques. An additional method to reduce CIED infection may be the use of antibacterial TYRX™ envelope. Data from non-randomised cohort studies have indicated that antibacterial envelope use can reduce the incidence of CIED infection by more than 80 % in high-risk patients and a randomised clinical trial is ongoing.
植入式心脏电子设备（CIED）植入后感染的发生率正以比设备植入率更快的速度上升。CIED感染患者通常需要住院，并完全移除设备和导线。相当一部分患者死于感染。经静脉导线拔除术（TLE）会引发罕见但严重的并发症，包括重大血管损伤或心脏穿孔。术者经验以及导线拔除方法的进步，包括激光技术和旋转鞘管，已使手术的并发症和死亡率风险降低。预防CIED感染的策略包括静脉使用抗生素和无菌手术技术。另一种降低CIED感染的方法可能是使用抗菌TYRX™包膜。非随机队列研究的数据表明，在高危患者中使用抗菌包膜可使CIED感染发生率降低80%以上，一项随机临床试验正在进行中。
