Abstract
Transvenous leads of cardiac rhythm devices (CRDs) are known to cause central stenosis and are vulnerable to contamination during hemodialysis access-related bacteremia. In this retrospective study, nine consecutive chronic hemodialysis patients with transvenous CRD infection due to dialysis access-related bacteremia and recurrent central stenosis are presented. Four patients with tunneled hemodialysis catheters (TDCs) and three with arteriovenous grafts experienced access-related bacteremia that spread to the transvenous CRD. Two patients required repeated angioplasty procedures (less than 3months apart) for central venous stenosis. Transvenous CRD was removed and replaced with an epicardial system in all. One patient with TDC switched to peritoneal dialysis and did not experience infection of the epicardial system despite two episodes of peritonitis. The remaining TDC (n=3) and graft patients (n=3) received a new TDC after the resolution of bacteremia. While all six experienced on average 1.5 episodes of catheter-related bacteremia (average follow-up = 14.5months), none developed infection of the epicardial system. The patients with central stenosis have required only one angioplasty each for the past 8 and 6months. To the best of our knowledge this is the first study to suggest that an epicardial approach might be a preferred method over transvenous leads for chronic hemodialysis patients.
| Original language | English |
|---|---|
| Pages (from-to) | 88-94 |
| Number of pages | 7 |
| Journal | Seminars in Dialysis |
| Volume | 25 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 1 2012 |
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ASJC Scopus subject areas
- Nephrology
Cite this
Epicardial cardiac rhythm devices for dialysis patients : Minimizing the risk of infection and preserving central veins. / Asif, Arif; Carrillo, Roger; Garisto, Juan Domingo; Lopera, Gustavo; Ladino, Marco; Barakat, Urwa; Eid, Nadia; Salman, Loay.
In: Seminars in Dialysis, Vol. 25, No. 1, 01.01.2012, p. 88-94.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Epicardial cardiac rhythm devices for dialysis patients
T2 - Minimizing the risk of infection and preserving central veins
AU - Asif, Arif
AU - Carrillo, Roger
AU - Garisto, Juan Domingo
AU - Lopera, Gustavo
AU - Ladino, Marco
AU - Barakat, Urwa
AU - Eid, Nadia
AU - Salman, Loay
PY - 2012/1/1
Y1 - 2012/1/1
N2 - Transvenous leads of cardiac rhythm devices (CRDs) are known to cause central stenosis and are vulnerable to contamination during hemodialysis access-related bacteremia. In this retrospective study, nine consecutive chronic hemodialysis patients with transvenous CRD infection due to dialysis access-related bacteremia and recurrent central stenosis are presented. Four patients with tunneled hemodialysis catheters (TDCs) and three with arteriovenous grafts experienced access-related bacteremia that spread to the transvenous CRD. Two patients required repeated angioplasty procedures (less than 3months apart) for central venous stenosis. Transvenous CRD was removed and replaced with an epicardial system in all. One patient with TDC switched to peritoneal dialysis and did not experience infection of the epicardial system despite two episodes of peritonitis. The remaining TDC (n=3) and graft patients (n=3) received a new TDC after the resolution of bacteremia. While all six experienced on average 1.5 episodes of catheter-related bacteremia (average follow-up = 14.5months), none developed infection of the epicardial system. The patients with central stenosis have required only one angioplasty each for the past 8 and 6months. To the best of our knowledge this is the first study to suggest that an epicardial approach might be a preferred method over transvenous leads for chronic hemodialysis patients.
AB - Transvenous leads of cardiac rhythm devices (CRDs) are known to cause central stenosis and are vulnerable to contamination during hemodialysis access-related bacteremia. In this retrospective study, nine consecutive chronic hemodialysis patients with transvenous CRD infection due to dialysis access-related bacteremia and recurrent central stenosis are presented. Four patients with tunneled hemodialysis catheters (TDCs) and three with arteriovenous grafts experienced access-related bacteremia that spread to the transvenous CRD. Two patients required repeated angioplasty procedures (less than 3months apart) for central venous stenosis. Transvenous CRD was removed and replaced with an epicardial system in all. One patient with TDC switched to peritoneal dialysis and did not experience infection of the epicardial system despite two episodes of peritonitis. The remaining TDC (n=3) and graft patients (n=3) received a new TDC after the resolution of bacteremia. While all six experienced on average 1.5 episodes of catheter-related bacteremia (average follow-up = 14.5months), none developed infection of the epicardial system. The patients with central stenosis have required only one angioplasty each for the past 8 and 6months. To the best of our knowledge this is the first study to suggest that an epicardial approach might be a preferred method over transvenous leads for chronic hemodialysis patients.
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UR - http://www.scopus.com/inward/citedby.url?scp=84856301877&partnerID=8YFLogxK
U2 - 10.1111/j.1525-139X.2010.00757.x
DO - 10.1111/j.1525-139X.2010.00757.x
M3 - Article
C2 - 20807391
AN - SCOPUS:84856301877
VL - 25
SP - 88
EP - 94
JO - Seminars in Dialysis
JF - Seminars in Dialysis
SN - 0894-0959
IS - 1
ER -