Transvenous cardiac implantable electronic devices and hemodialysis catheters: Recommendations to curtail a potentially lethal combination

Arif Asif, Loay Salman, Gustavo Lopera, Syed S. Haqqie, Roger Carrillo

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Abnormal renal function is an independent risk factor for cardiac implantable electronic device (CIED) infection. The risk of CIED infection increases as the degree of renal dysfunction worsens with the highest risk observed in patients with stage V chronic kidney disease. A significant portion of these patients use a tunneled hemodialysis catheter (TDC) for dialysis therapy. These devices are associated with very high rates of catheter-related bacteremia (1.6-5.5 episodes of bacteremia per 1000 catheter days), and have been known to cause infection of CIED indwelling in the bloodstream. In this context, the cardiac device is exposed to the risk of infection due to the presence of renal failure and episodes of bacteremia related to TDCs. Both increase the risk of CIED infection. Once infected, a cardiac rhythm device carries a marked increase in morbidity and mortality. In this context, the combination of a TDC and a CIED indwelling in the bloodstream becomes a potentially deadly combination. Recent data have emphasized that epicardial CIED implantation reduces cardiac device infection in TDC patients. This report highlights the risk of CIED infection in renal patients, presents TDC's contribution to the cardiac device infection, and suggests recommendations to minimize the risk of CIED infection in chronic hemodialysis patients dialyzing with a TDC.

Original languageEnglish (US)
Pages (from-to)582-586
Number of pages5
JournalSeminars in Dialysis
Volume25
Issue number5
DOIs
StatePublished - Sep 1 2012

ASJC Scopus subject areas

  • Nephrology

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