Diagnosis and management of subcutaneous implantable cardioverter-defibrillator infections based on process mapping

• Type of Material: Article
• Authors: Larry M. Baddour, Mayo Clinic; Raul Weiss, Ohio State University; George E. Mark, Cooper University Hospital; Mikhael El Chami, Emory University; Mauro Biffi, St Orsola Marcello Malpighi Hospital; Vincent Probst, CHU de Nantes; Pier D. Lambiase, UCL Institute of Cardiovascular Science; Marc A. Miller, Mt Sinai Hospital; Timothy McClernon, People Architects Inc; Linda K. Hansen, Boston Scientific Corporation; Bradley P. Knight, Northwestern Memorial Hospital
• Language: English
• Date: 2020-04-23
• Publisher: Wiley
• Publication Version: Final Published Version
• Copyright Statement: © 2020 The Authors. Pacing and Clinical Electrophysiology published by Wiley Periodicals LLC.
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1111/pace.13902
• Title of Journal or Parent Work: Pacing and Clinical Electrophysiology
• Volume: 43
• Issue: 9
• Start Page: 958
• End Page: 965
• Grant/Funding Information: None declared
• Keywords: subcutaneous implantable cardioverter-defibrillator; Trends; Outcomes; extraction; Efficacy; Life Sciences & Biomedicine; Predictors; Cardiac & Cardiovascular Systems; Engineering, Biomedical; mapping; infection; Trial; Cardiovascular System & Cardiology; antibiotics; diagnosis; Engineering; Electronic device infections; Safety; Statement; Science & Technology; Technology
• Research Categories: Engineering, Biomedical; Health Sciences, Epidemiology; Biology, Physiology

Abstract

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.