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Managing Pacemaker and Implantable Defibrillator Site Infections Conservatively at a Caribbean Cardiac Center

Journal Authors: 


Infections of cardiac rhythm devices, such as pacemakers and defibrillators have seen a steady worldwide increase. In the past, high rates of infection recurrence and mortality with antibiotic-only treatment prompted the expert recommendation that all infections be managed by device and lead removal and replacement. In certain patients, however, device removal is risky and costly, leading to a reexamination of conservative treatment in these patients. We present a case series of nine patients treated by intravenous antibiotics coupled with antibiotic solution wound irrigation and lavage. The mean period of follow-up was 25 months, ranging from six to 60 months. At last follow-up, all patients remained infection-free and were still alive. This report is the first of its kind in the Caribbean region and a valuable addition to the literature on alternatives to device removal, especially in resource-constricted settings, and may be applied successfully to patients who present early with infections localized to the pocket. 

18 Dec, 2017
e-Published: 20 Dec, 2017


Manuscripts that are Published Ahead of Print have been peer reviewed and accepted for publication by the Editorial Board of the West Indian Medical Journal. They may appear in their original format and may not be copy edited or formatted in the style guide of this Journal. While accepted manuscripts are not yet assigned a volume, issue or page numbers, they can be cited using the DOI and date of e-publication. See our Instructions for Authors on how to properly cite manuscripts at this stage. The contents of the manuscript may change before it is published in its final form. Manuscripts in this section will be removed once they have been issued to a volume and issue, but will still retain the DOI and date of e-publication.

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