{"title":"使用庆大霉素-胶原海绵预防植入式心律转复除颤器患者感染的效果--单中心 ICD 登记观察研究的结果。","authors":"Thomas Kleemann MD , Babak Mousavi MD , Kleopatra Kouraki MD , Margit Strauss MD , Anne-Rike Wenz MD , Ahmet Enes Öztürk MD , Udo Weisse MD , Christiane Werling MD , Falk-Udo Sack MD , Ralf Zahn MD","doi":"10.1016/j.hrthm.2025.03.1963","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Despite the obvious benefits, the use of implantable cardioverter defibrillators (ICDs) is associated with serious complications, including infections. In particular, device replacement or revision procedures are associated with an increased risk of infection.</div></div><div><h3>Objective</h3><div>The aim of the study was to compare the cardiac device infection rate with and without the use of a gentamycin-collagen sponge (GCS) in patients undergoing device replacement or revision procedures of implanted ICDs.</div></div><div><h3>Methods</h3><div>A total of 507 consecutive ICD patients from a prospective single-center ICD registry who underwent elective device replacement, system upgrade, or lead revision between 2017 and April 2024 were analyzed. From September 2020 onwards a GCS was inserted into the device pocket (GCS group, n = 277). These patients were compared with patients who underwent surgery between 2017 and August 2020 (control group, n = 230).</div></div><div><h3>Results</h3><div>The baseline characteristics were similar between both groups. The GCS was well tolerated, and no complications were associated with the GCS. The Kaplan-Meier estimated infection rate after 1 year was 0.7% in the GCS group and 3.9% in the control group (<em>P</em> = .005). The use of the GCS was an independent predictor for a lower device infection rate during follow-up (hazard ratio [HR], 0.23, 95% confidence interval [CI], 0.07–0.84).</div></div><div><h3>Conclusion</h3><div>The additional use of a GCS was associated with a lower incidence of device infections than standard-of-care infection prevention strategies alone.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"23 2","pages":"Pages 418-423"},"PeriodicalIF":7.0000,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Efficacy of a gentamycin-collagen sponge to prevent infections in patients with an implantable cardioverter defibrillator undergoing device replacement or lead revision: Results of a monocentric ICD registry observational study\",\"authors\":\"Thomas Kleemann MD , Babak Mousavi MD , Kleopatra Kouraki MD , Margit Strauss MD , Anne-Rike Wenz MD , Ahmet Enes Öztürk MD , Udo Weisse MD , Christiane Werling MD , Falk-Udo Sack MD , Ralf Zahn MD\",\"doi\":\"10.1016/j.hrthm.2025.03.1963\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Despite the obvious benefits, the use of implantable cardioverter defibrillators (ICDs) is associated with serious complications, including infections. In particular, device replacement or revision procedures are associated with an increased risk of infection.</div></div><div><h3>Objective</h3><div>The aim of the study was to compare the cardiac device infection rate with and without the use of a gentamycin-collagen sponge (GCS) in patients undergoing device replacement or revision procedures of implanted ICDs.</div></div><div><h3>Methods</h3><div>A total of 507 consecutive ICD patients from a prospective single-center ICD registry who underwent elective device replacement, system upgrade, or lead revision between 2017 and April 2024 were analyzed. From September 2020 onwards a GCS was inserted into the device pocket (GCS group, n = 277). These patients were compared with patients who underwent surgery between 2017 and August 2020 (control group, n = 230).</div></div><div><h3>Results</h3><div>The baseline characteristics were similar between both groups. The GCS was well tolerated, and no complications were associated with the GCS. The Kaplan-Meier estimated infection rate after 1 year was 0.7% in the GCS group and 3.9% in the control group (<em>P</em> = .005). The use of the GCS was an independent predictor for a lower device infection rate during follow-up (hazard ratio [HR], 0.23, 95% confidence interval [CI], 0.07–0.84).</div></div><div><h3>Conclusion</h3><div>The additional use of a GCS was associated with a lower incidence of device infections than standard-of-care infection prevention strategies alone.</div></div>\",\"PeriodicalId\":12886,\"journal\":{\"name\":\"Heart rhythm\",\"volume\":\"23 2\",\"pages\":\"Pages 418-423\"},\"PeriodicalIF\":7.0000,\"publicationDate\":\"2026-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Heart rhythm\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1547527125022003\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/3/18 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Heart rhythm","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1547527125022003","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/18 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Efficacy of a gentamycin-collagen sponge to prevent infections in patients with an implantable cardioverter defibrillator undergoing device replacement or lead revision: Results of a monocentric ICD registry observational study
Background
Despite the obvious benefits, the use of implantable cardioverter defibrillators (ICDs) is associated with serious complications, including infections. In particular, device replacement or revision procedures are associated with an increased risk of infection.
Objective
The aim of the study was to compare the cardiac device infection rate with and without the use of a gentamycin-collagen sponge (GCS) in patients undergoing device replacement or revision procedures of implanted ICDs.
Methods
A total of 507 consecutive ICD patients from a prospective single-center ICD registry who underwent elective device replacement, system upgrade, or lead revision between 2017 and April 2024 were analyzed. From September 2020 onwards a GCS was inserted into the device pocket (GCS group, n = 277). These patients were compared with patients who underwent surgery between 2017 and August 2020 (control group, n = 230).
Results
The baseline characteristics were similar between both groups. The GCS was well tolerated, and no complications were associated with the GCS. The Kaplan-Meier estimated infection rate after 1 year was 0.7% in the GCS group and 3.9% in the control group (P = .005). The use of the GCS was an independent predictor for a lower device infection rate during follow-up (hazard ratio [HR], 0.23, 95% confidence interval [CI], 0.07–0.84).
Conclusion
The additional use of a GCS was associated with a lower incidence of device infections than standard-of-care infection prevention strategies alone.
期刊介绍：
HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability.
HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community.
The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.
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