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Process Mapping Strategies to Prevent Subcutaneous Implantable Cardioverter-Defibrillator Infection
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  • Raul Weiss,
  • George Mark,
  • Mikhael El-Chami,
  • Mauro Biffi,
  • Pier Lambiase,
  • Marc Miller,
  • Timothy McClernon,
  • Linda Hansen,
  • Bradley Knight,
  • Larry Baddour
Raul Weiss
Ohio State University

Corresponding Author:[email protected]

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George Mark
Cooper University Health Care
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Mikhael El-Chami
Emory University
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Mauro Biffi
University of Bologna
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l'institut du thorax, CHU de Nantes
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Pier Lambiase
Barts Heart Centre, Barts Health NHS trust
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Marc Miller
Mount Sinai School of Medicine
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Timothy McClernon
People Architects
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Linda Hansen
Inari Medical Inc
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Bradley Knight
Northwestern University
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Larry Baddour
Mayo Clinic
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Background: Infection remains a major complication of cardiac implantable electronic devices (CIEDs) and can lead to significant morbidity and mortality. Extrathoracic devices that avoid epicardial or transvenous leads, such as the subcutaneous implantable cardioverter-defibrillator (S-ICD), can reduce the risk of serious infection-related complications, such as bloodstream infection and infective endocarditis. While the 2017 AHA/ACC/HRS guidelines include recommendations for S-ICD use for patients at high risk of infection, currently, there are no clinical trial data that address best practices for the prevention of S-ICD infections. Therefore, an expert panel was convened to develop consensus on these topics. Methods: An expert process mapping methodology was used to achieve consensus on the appropriate steps to minimize or prevent S-ICD infections. Two face-to-face meetings of high-volume S-ICD implanters and an infectious diseases specialist, with expertise on cardiovascular implantable electronic device infections, were conducted to develop consensus on useful strategies pre-, peri-, and post-implant to reduce S-ICD infection risk. Results: Expert panel consensus of recommended steps for patient preparation, S-ICD implantation, and post-operative management were developed to provide guidance in individual patient management. Conclusion: Achieving expert panel consensus by process mapping methodology for S-ICD infection prevention was attainable, and the results should be helpful to clinicians in adopting interventions to minimize risks of S-ICD infection.
02 Dec 2021Submitted to Journal of Cardiovascular Electrophysiology
11 Dec 2021Submission Checks Completed
11 Dec 2021Assigned to Editor
03 Jan 2022Reviewer(s) Assigned
18 Jan 2022Review(s) Completed, Editorial Evaluation Pending
31 Jan 2022Editorial Decision: Revise Minor
20 Apr 20221st Revision Received
04 May 2022Submission Checks Completed
04 May 2022Assigned to Editor
04 May 2022Reviewer(s) Assigned
15 May 2022Review(s) Completed, Editorial Evaluation Pending
26 May 2022Editorial Decision: Accept
Jul 2022Published in Journal of Cardiovascular Electrophysiology volume 33 issue 7 on pages 1628-1635. 10.1111/jce.15566