基于流程映射的皮下植入式心律转复除颤器感染的诊断和管理。
Diagnosis and management of subcutaneous implantable cardioverter-defibrillator infections based on process mapping.
机构信息
Division of Infectious Diseases, Department of Medicine, and Department of Cardiovascular Diseases, Mayo Clinic College of Medicine and Science, Rochester, Minnesota.
The Ohio State University Wexner Medical Center, Cardiology, DHLRI, Columbus, Ohio.
出版信息
Pacing Clin Electrophysiol. 2020 Sep;43(9):958-965. doi: 10.1111/pace.13902. Epub 2020 Apr 23.
BACKGROUND
Infection is a well-recognized complication of cardiovascular implantable electronic device (CIED) implantation, including the more recently available subcutaneous implantable cardioverter-defibrillator (S-ICD). Although the AHA/ACC/HRS guidelines include recommendations for S-ICD use, currently there are no clinical trial data that address the diagnosis and management of S-ICD infections. Therefore, an expert panel was convened to develop consensus on these topics.
METHODS
A process mapping methodology was used to achieve a primary goal - the development of consensus on the diagnosis and management of S-ICD infections. Two face-to-face meetings of panel experts were conducted to recommend useful information to clinicians in individual patient management of S-ICD infections.
RESULTS
Panel consensus of a stepwise approach in the diagnosis and management was developed to provide guidance in individual patient management.
CONCLUSION
Achieving expert panel consensus by process mapping methodology in S-ICD infection diagnosis and management was attainable, and the results should be helpful in individual patient management.
背景
感染是心血管植入式电子设备（CIED）植入的一种公认的并发症，包括最近出现的皮下植入式心律转复除颤器（S-ICD）。尽管 AHA/ACC/HRS 指南包括 S-ICD 使用的建议，但目前尚无临床试验数据可用于解决 S-ICD 感染的诊断和管理问题。因此，召集了一个专家小组来就这些问题达成共识。
方法
使用流程映射方法实现了一个主要目标 - 就 S-ICD 感染的诊断和管理达成共识。进行了两次专家组面对面会议，为个别患者的 S-ICD 感染管理推荐了对临床医生有用的信息。
结果
制定了诊断和管理的逐步方法的小组共识，为个别患者管理提供指导。
结论
通过流程映射方法在 S-ICD 感染诊断和管理方面达成专家小组共识是可行的，结果应有助于个别患者的管理。
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