Rhythm

Question 1

RFs for failure of Radiofrequency ablation

Answer 1

LA > 60mm
chronic AF > 6 months,
low amplitude waves
MV disease

Question 2

causative organisms of PPM/ICD infections

Answer 2

1. CoNStaphylococci (40%)
2. MSSA/MRSA (25%/4%)
3. Gm Neg bacilli (inc. pseudomonas)
4. polymicrobial
5. culture neg
6. other gm pos cocci (i.e. enterococcus faecalis)
7. fungal (candida)

Question 3

RFs for CIED infections

Answer 3

patient:

• DM
• HF
• renal dysfunction (eGFR

Question 4

define biofilm

Answer 4

surface-associatd community of 1 or more microbial sp. that are firmly attached to each other and the solid surface and are encased in an extracellular polymeric matrix (fibrinogen, fibrinectin, collagen) that holds the biofilm together.

• more resistant to antibiotics & host defenses

Question 5

device adherence by bacterial increased by

Answer 5

1. greater degree of hydrophobicity

2. irregular surface

Question 6

risks of percutaneous lead extraction

Answer 6

1. tamponade
2. hemothorax
3. lead migration
4. Pulm Embolism
5. death

Question 7

indication for primary surgical lead extraction

Answer 7

vegetation greater than 20mm

surgeon to decide

Question 8

complications of CIED infections

Answer 8

contiguous
1. chest wall abscess
2. septic thombophlebitis
3. right heart IE
remote
1. skeletal: clavicular osteomyelitis, sternoclavicular arthritis, metastatic osteomyelitis, discitis, and septic arthritis
2. cardiopulmonary: septic PE, mycotic pulm art aneurysm left sided IE
3. soft tissue, organ or muscle abscess
4. sepsis

Question 9

mortality assoc’d w CIED infections

Answer 9

18% @ 6mths

Question 10

RFs for mortality w CIED infections

Answer 10

1. sys embolization
2. mod-severe TR
3. RV dysfunction
4. renal dysfunction