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3 results on '"MESH : Pacemaker, Artificial"'

1. Clinical characteristics and outcome of infective endocarditis involving implantable cardiac devices

Author

David Gordon, Emilio Bouza, Víctor José González Ramallo, Christine Selton-Suty, Francesc Marco, Eugene Athan, Emanuele Durante-Mangoni, Anna Lisa Chamis, Zainab Samad, Nuria Fernández-Hidalgo, Carlos Cervera, Jorge Solis, Corentine ALAUZET, François Alla, Sarah Israel, Hussien Rizk, Patricia Carmen Muñoz García, Andrew Wang, Juan M Pericas, Souha Kanj, Carlos Falces, Pierre-Edouard Fournier, Assoc Prof Margaret J Henry, Asunción Moreno Camacho, Martin Stryjewski, Antonio Toniolo, Didier Raoult, Service des maladies infectieuses et réanimation médicale, Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou, Monaldi Hospital, Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Service des maladies infectieuses et tropicales, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, Département de Cardiologie, Assistance Publique - Hôpitaux de Marseille ( APHM ) - Hôpital de la Timone [CHU - APHM] ( TIMONE ), Ministerio de Sanidad y Consumo, Instituto de Salud Carlos III, Madrid, Spain - Spanish Network for Research in Infectious Diseases (REIPI RD06/0008), ICE-PCS Investigators, Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Laboratoire Chrono-environnement (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), and Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE)

Subjects
Male, Pacemaker, Artificial, MESH: Endocarditis, MESH : Prevalence, [SDV]Life Sciences [q-bio], Heart Valve Diseases, MESH : Aged, MESH : Prospective Studies, MESH: Hospitalization, 030204 cardiovascular system & hematology, 0302 clinical medicine, prevention, MESH: Tricuspid Valve, Interquartile range, MESH : Device Removal, Prevalence, MESH : Female, Hospital Mortality, Prospective Studies, 030212 general & internal medicine, Endocarditis, prosthesis, infection, etiology, survival, Prospective cohort study, MESH: Treatment Outcome, MESH: Aged, Cross Infection, MESH: Middle Aged, Infective endocarditis, Impalntable cardiac device, Mortality rate, Hazard ratio, General Medicine, Middle Aged, Staphylococcal Infections, MESH : Tricuspid Valve, MESH : Endocarditis, Defibrillators, Implantable, 3. Good health, MESH : Heart Valve Diseases, Hospitalization, Treatment Outcome, MESH: Survival Analysis, MESH: Pacemaker, Artificial, MESH : Hospitalization, Female, Tricuspid Valve, MESH : Cross Infection, Cohort study, medicine.medical_specialty, MESH : Male, MESH: Staphylococcal Infections, [SDU.STU.PE]Sciences of the Universe [physics]/Earth Sciences/Petrography, Context (language use), MESH : Treatment Outcome, MESH: Defibrillators, Implantable, MESH : Hospital Mortality, 03 medical and health sciences, Internal medicine, medicine, Humans, MESH : Middle Aged, MESH: Hospital Mortality, MESH: Device Removal, Device Removal, MESH: Prevalence, Aged, [ SDU.STU.PE ] Sciences of the Universe [physics]/Earth Sciences/Petrography, MESH: Humans, [ SDV ] Life Sciences [q-bio], business.industry, MESH : Pacemaker, Artificial, MESH : Humans, MESH: Cross Infection, MESH: Heart Valve Diseases, medicine.disease, Survival Analysis, MESH: Male, MESH: Prospective Studies, Surgery, MESH : Staphylococcal Infections, MESH : Survival Analysis, business, MESH: Female, MESH : Defibrillators, Implantable
Abstract

International audience; CONTEXT: Infection of implantable cardiac devices is an emerging disease with significant morbidity, mortality, and health care costs. OBJECTIVES: To describe the clinical characteristics and outcome of cardiac device infective endocarditis (CDIE) with attention to its health care association and to evaluate the association between device removal during index hospitalization and outcome. DESIGN, SETTING, AND PATIENTS: Prospective cohort study using data from the International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS), conducted June 2000 through August 2006 in 61 centers in 28 countries. Patients were hospitalized adults with definite endocarditis as defined by modified Duke endocarditis criteria. MAIN OUTCOME MEASURES: In-hospital and 1-year mortality. RESULTS: CDIE was diagnosed in 177 (6.4% [95% CI, 5.5%-7.4%]) of a total cohort of 2760 patients with definite infective endocarditis. The clinical profile of CDIE included advanced patient age (median, 71.2 years [interquartile range, 59.8-77.6]); causation by staphylococci (62 [35.0% {95% CI, 28.0%-42.5%}] Staphylococcus aureus and 56 [31.6% {95% CI, 24.9%-39.0%}] coagulase-negative staphylococci); and a high prevalence of health care-associated infection (81 [45.8% {95% CI, 38.3%-53.4%}]). There was coexisting valve involvement in 66 (37.3% [95% CI, 30.2%-44.9%]) patients, predominantly tricuspid valve infection (43/177 [24.3%]), with associated higher mortality. In-hospital and 1-year mortality rates were 14.7% (26/177 [95% CI, 9.8%-20.8%]) and 23.2% (41/177 [95% CI, 17.2%-30.1%]), respectively. Proportional hazards regression analysis showed a survival benefit at 1 year for device removal during the initial hospitalization (28/141 patients [19.9%] who underwent device removal during the index hospitalization had died at 1 year, vs 13/34 [38.2%] who did not undergo device removal; hazard ratio, 0.42 [95% CI, 0.22-0.82]). CONCLUSIONS: Among patients with CDIE, the rate of concomitant valve infection is high, as is mortality, particularly if there is valve involvement. Early device removal is associated with improved survival at 1 year.

Published
2012
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2. Characteristics and long-term outcome of non-immune isolated atrioventricular block diagnosed in utero or early childhood: a multicentre study

Author

François Marçon, Caroline Bonnet, Sophie Guillaumont, Elisabeth Villain, Véronique Gournay, François Godart, Albin Behaghel, Yves Dulac, Jean-Benoit Thambo, Swanny Fouchard, Vincent Probst, Jean-Jacques Schott, Jean-Marc Schleich, Alain Chantepie, Francis Rouault, Christophe Leclercq, Alban-Elouen Baruteau, Alain Fraisse, Hervé Le Marec, Jean-Claude Daubert, Jean-René Lusson, Philippe Mabo, Service de cardiologie et maladies vasculaires, Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut du thorax, Université de Nantes ( UN ) -IFR26-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Laboratoire Traitement du Signal et de l'Image ( LTSI ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), unité de recherche de l'institut du thorax UMR1087 UMR6291 ( ITX ), Université de Nantes ( UN ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Service de cardiologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Service cardiologie pédiatrique [Bordeaux], CHU Bordeaux [Bordeaux], Service de Cardiologie Infantile [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Service de cardiologie pédiatrique [Nantes], Centre hospitalier universitaire de Nantes ( CHU Nantes ), Cabinet de Cardiologie pédiatrique, Service de cardiologie pédiatrique [Tours], CHU Tours, Service de cardiologie Pédiatrique [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ), Service de cardiologie Pédiatrique [Lille], Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Service de cardiologie pédiatrique et congénitale adulte [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Service de cardiologie Pédiatrique [Marseille], Hôpital de la Timone [CHU - APHM] ( TIMONE ), Service de cardiologie [Clermont-Ferrand], CHU Clermont-Ferrand, Service pédiatrie-cardiologie, CHU Toulouse [Toulouse]-Hôpital des Enfants, 'Protocole Hospitalier de Recherche Clinique' 2001 R20/03 and 2004 R20/07 from the University Medical Center of Nantes, France, the 2009 Philippe Coumel Research Grant from the French Society of Cardiology, grant no 05 CVD 01 (Preventing Sudden Death) from the Foundation Leducq Trans-Atlantic Network of Excellence, 'Agence Nationale de la Recherche' grant 05-MRAR-028., Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Nantes (UN)-IFR26-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital de la Timone [CHU - APHM] (TIMONE), Service de Cardiologie Maladies Vasculaires [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, CHU Toulouse [Toulouse], Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de recherche de l'institut du thorax (ITX-lab), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Service Cardiologie pédiatrique [CHU Toulouse], Pôle Enfants [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS)

Subjects
Male, Pacemaker, Artificial, Heart disease, MESH : Retrospective Studies, law.invention, Electrocardiography, 0302 clinical medicine, MESH: Pregnancy, MESH : Child, Pregnancy, Prenatal Diagnosis, MESH: Child, Age of Onset, Child, MESH: Treatment Outcome, MESH: Bundle-Branch Block, Clinical outcome, Cardiac Pacing, Artificial, MESH : Infant, MESH: Infant, 3. Good health, MESH : Age of Onset, Pacemaker, MESH: Young Adult, MESH : Electrocardiography, Child, Preschool, Disease Progression, MESH: Pacemaker, Artificial, MESH: Disease Progression, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, MESH : Bundle-Branch Block, MESH: Age of Onset, MESH : Young Adult, MESH: Cardiac Pacing, Artificial, Disease-Free Survival, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, MESH : Adolescent, Humans, MESH: Prenatal Diagnosis, MESH : Prenatal Diagnosis, Retrospective Studies, MESH: Adolescent, MESH: Humans, MESH: Child, Preschool, MESH : Humans, Infant, MESH: Adult, MESH: Retrospective Studies, MESH : Disease Progression, medicine.disease, MESH : Pregnancy, MESH: Disease-Free Survival, Atrioventricular block, MESH: Female, Pediatrics, Paediatric electrocardiology, 030204 cardiovascular system & hematology, MESH : Child, Preschool, Risk Factors, law, MESH: Risk Factors, MESH : Female, [ SDV.IB ] Life Sciences [q-bio]/Bioengineering, medicine.diagnostic_test, Dilated cardiomyopathy, MESH : Adult, [ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, MESH : Risk Factors, MESH : Atrioventricular Block, Treatment Outcome, MESH : Disease-Free Survival, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, medicine.symptom, Adult, Adolescent, MESH : Male, Bundle-Branch Block, MESH : Treatment Outcome, Asymptomatic, Young Adult, MESH: Atrioventricular Block, 030225 pediatrics, medicine, business.industry, MESH : Pacemaker, Artificial, Retrospective cohort study, MESH: Male, Surgery, MESH: Electrocardiography, MESH : Cardiac Pacing, Artificial, Artificial cardiac pacemaker, Age of onset, business
Abstract

International audience; AIMS: The natural history of congenital or childhood non-immune, isolated atrioventricular (AV) block is poorly defined. METHODS AND RESULTS: We retrospectively studied 141 children with isolated, non-immune AV block diagnosed in utero, or up to 15 years of age, at 13 French medical centres, between 1980 and 2009. Patients with structural heart disease or maternal antibodies were excluded. Atrioventricular block was asymptomatic in 119 (84.4%) and complete in 100 (70.9%) patients. There was progression to complete AV block in 29/41 (70.7%) patients with incomplete AV block over 2.8 ± 3.4 years (1-155 months), but all patients with incomplete AV block may not have been included in the study. Narrow QRS complex was present in 18 of 26 patients (69.2%) with congenital, and 106 of 115 (92.2%) with childhood AV block. Pacemakers were implanted in 112 children (79.4%), during the first year of life in 18 (16.1%) and before 10 years of age in 90 (80.4%). The mean interval between diagnosis of AV block and pacemaker implants was 2.6 ± 3.9 years (0-300 months). The pacing indication was prophylactic in 70 children (62.5%). During a mean follow-up of 11.6 ± 6.7 years (1-32 years), no patient died or developed dilated cardiomyopathy (DCM). The long-term follow-up was uncomplicated in 127 children (90.1%). CONCLUSION: In this large multicentre study, the long-term outcome of congenital or childhood non-immune, isolated AV block was favourable, regardless of the patient's age at the time of diagnosis. No patient died or developed DCM, and pacemaker-related complications were few.

Published
2012
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3. Emergence of coagulase-negative staphylococci as a cause of native valve endocarditis

Author

Christopher H. Cabell, Pilar Tornos, Paul A. Pappas, David L. Gordon, Christopher W. Woods, Bruno Hoen, Tom S.J. Elliott, Eugene Athan, Francesc Marco, Claudio Querido Fortes, Francisco Nacinovich, G. Ralph Corey, Jerome J. Federspiel, Vivian H. Chu, Riccardo Utili, José M. Miró, Vance G. Fowler, Martin E. Stryjewski, Donald P. Levine, François Delahaye, Service des maladies infectieuses et tropicales, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)

Subjects
Male, Pacemaker, Artificial, Staphylococcus, MESH : Aged, MESH : Prospective Studies, MESH : Coagulase, Heart Valve Diseases, 030204 cardiovascular system & hematology, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Epidemiology, MESH : Female, Prospective Studies, MESH : Endocarditis, Bacterial, Prospective cohort study, MESH: Aged, 0303 health sciences, Cross Infection, MESH: Middle Aged, Mortality rate, cons, MESH: Staphylococcus, MESH : Adult, Middle Aged, MESH : Heart Valve Diseases, 3. Good health, Community-Acquired Infections, [ SDV.MHEP.MI ] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Infectious Diseases, MESH: Community-Acquired Infections, MESH: Pacemaker, Artificial, Female, MESH: Coagulase, MESH : Cross Infection, MESH : Community-Acquired Infections, Microbiology (medical), Adult, Coagulase, medicine.medical_specialty, MESH : Male, 03 medical and health sciences, Internal medicine, medicine, Endocarditis, Humans, MESH : Middle Aged, MESH: Endocarditis, Bacterial, MESH : Staphylococcus, Aged, Heart Failure, Native Valve Endocarditis, MESH: Humans, MESH: Methicillin Resistance, 030306 microbiology, business.industry, MESH : Pacemaker, Artificial, MESH : Humans, MESH: Cross Infection, MESH: Adult, Odds ratio, Endocarditis, Bacterial, MESH: Heart Valve Diseases, medicine.disease, MESH: Male, MESH: Prospective Studies, MESH : Methicillin Resistance, Surgery, Bacteremia, MESH: Heart Failure, Methicillin Resistance, MESH : Heart Failure, business, MESH: Female
Abstract

International audience; BACKGROUND: Coagulase-negative staphylococci (CoNS) are an infrequent cause of native valve endocarditis (NVE), and our understanding of NVE caused by CoNS is incomplete. METHOD: The International Collaboration on Endocarditis-Prospective Cohort Study includes patients with endocarditis from 61 centers in 28 countries. Patients with definite cases of NVE caused by CoNS who were enrolled during the period June 2000-August 2006 were compared with patients with definite cases of NVE caused by Staphylococcus aureus and patients with NVE caused by viridans group streptococci. Multivariable logistic regression was used to determine factors associated with death in patients with NVE caused by CoNS. RESULTS: Of 1635 patients with definite NVE and no history of injection drug use, 128 (7.8%) had NVE due to CoNS. Health care-associated infection occurred in 63 patients (49%) with NVE caused by CoNS. Comorbidities, long-term intravascular catheter use, and history of recent invasive procedures were similar among patients with NVE caused by CoNS and among patients with NVE caused by S. aureus. Surgical treatment for endocarditis occurred more frequently in patients with NVE due to CoNS (76 patients [60%]) than in patients with NVE due to S. aureus (150 [33%]; P=.01) or in patients with NVE due to viridans group streptococci (149 [44%]; P=.01). Despite the high rate of surgical procedures among patients with NVE due to CoNS, the mortality rates among patients with NVE due to CoNS and among patients with NVE due to S. aureus were similar (32 patients [25%] and 124 patients [27%], respectively; P=.44); the mortality rate among patients with NVE due to CoNS was higher than that among patients with NVE due to viridans group streptococci (24 [7.0%]; P=.01). Persistent bacteremia (odds ratio, 2.65; 95% confidence interval, 1.08-6.51), congestive heart failure (odds ratio, 3.35; 95% confidence interval, 1.57-7.12), and chronic illness (odds ratio, 2.86; 95% confidence interval, 1.34-6.06) were independently associated with death in patients with NVE due to CoNS (c index, 0.73). CONCLUSIONS: CoNS have emerged as an important cause of NVE in both community and health care settings. Despite high rates of surgical therapy, NVE caused by CoNS is associated with poor outcomes.

Published
2008
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