Process mapping strategies to prevent subcutaneous implantable cardioverter-defibrillator infections

other members of the S-ICD Process Mapping Consortium

Research output: Contribution to journalReview articlepeer-review

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.

Original languageEnglish
Pages (from-to)1628-1635
Number of pages8
JournalJournal of Cardiovascular Electrophysiology
Volume33
Issue number7
DOIs
StatePublished - Jul 2022

Keywords

  • antibiotic prophylaxis
  • antibiotics
  • defibrillator
  • infection
  • mapping
  • prevention
  • subcutaneous implantable cardioverter-defibrillator
  • surgical site infection

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