Evidence map›Paper›PMID 40259643›Full record

Observational studyJournal of cardiovascular electrophysiology2025

Clinical Impact of the Incision of the Capsule Floor During Generator Replacement on Cardiac Implantable Electronic Device Infection Risk: A Single-Center Experience.

Umut Celikyurt, Burak Acar, Hacer Dogan, Ipek Celikyurt, Kaan Hanci, Ozlem Guler, Aysen Agacdiken, Ahmet Vural

Abstract readObservational Study
In one paragraph

Observational study in Journal of cardiovascular electrophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Umut CelikyurtArrhythmia, Electrophysiology, Pacemaker Research and Management Center, Department of Cardiology, Kocaeli University Medical Faculty, Kocaeli, Turkey.ORCID 0000-0003-4957-7102
Burak AcarArrhythmia, Electrophysiology, Pacemaker Research and Management Center, Department of Cardiology, Kocaeli University Medical Faculty, Kocaeli, Turkey.
Hacer DoganArrhythmia, Electrophysiology, Pacemaker Research and Management Center, Department of Cardiology, Kocaeli University Medical Faculty, Kocaeli, Turkey.
Ipek CelikyurtDepartment of Pharmacology, Kocaeli University Medical Faculty, Kocaeli, Turkey.
Kaan HanciArrhythmia, Electrophysiology, Pacemaker Research and Management Center, Department of Cardiology, Kocaeli University Medical Faculty, Kocaeli, Turkey.
Ozlem GulerDepartment of Infectious Dieaseses, Kocaeli University Medical Faculty, Kocaeli, Turkey.
Aysen AgacdikenArrhythmia, Electrophysiology, Pacemaker Research and Management Center, Department of Cardiology, Kocaeli University Medical Faculty, Kocaeli, Turkey.
Ahmet VuralArrhythmia, Electrophysiology, Pacemaker Research and Management Center, Department of Cardiology, Kocaeli University Medical Faculty, Kocaeli, Turkey.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe fibrous capsule around cardiac implantable electronic device (CIED) generators represents avascular tissue that could be colonized and provides the nidus for latent infection. The purpose of the study is to evaluate the effects of incision of the capsule floor at the lower and/or medial part at the time of generator replacement on the CIED infection and hematoma formation.

methodsThis observational study with retrospective analysis of prospectively collected data included patients who underwent CIED generator replacement between January 2013 and January 2024. A total of 1059 consecutive patients were compared according to the incision of the capsule floor at the lower and/or medial part: 448 patients without (group 1) and 611 patients with an incision on the capsule floor (group 2).

resultsFifteen patients with CIED infection after generator replacement were identified. There were no significant differences between the two groups, except for a higher percentage of patients with number of previous procedures on pocket ≥ 2 (35% vs. 19.6%, p < 0.001), and NOAC use (10.6% vs. 6.7%, p = 0.027) in group 2. There was a lower infection rate in group 2 compared to group 1 (0.7% vs. 2.5%, p = 0.014). In multivariate analysis, independent predictors of CIED infection after generator replacement were replacement without an incision of the capsule floor (OR 4.384, 95% CI [1.355-14.189]; p = 0.014), and age< 65 years (OR 3.259, 95% CI [1.133-9.378]; p = 0.028).

conclusionGenerator replacement without incision of the capsule floor during generator replacement was associated with increased CIED infection risk. To minimize CIED infection risk, capsule floor incision could be considered during generator replacement.

Indexed as

Defibrillators, ImplantableDevice RemovalPacemaker, ArtificialProsthesis ImplantationProsthesis-Related InfectionsAgedAged, 80 and overFemaleHumansMaleMiddle AgedRetrospective StudiesRisk AssessmentRisk FactorsTime FactorsTreatment Outcomecardiac device infectionfibrous capsulegenerator replacement

Identifiers

PMID40259643
PMCPMC12246507

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.