シヨウダ　モリオ   Shiyouda Morio   庄田　守男    所属   医学部 医学科（東京女子医科大学病院）    職種   寄附部門教授
言語種別	日本語
発表タイトル	What should We Do for Pacemaker Infection Suspects
会議名	第83回日本循環器学会学術集会
主催者	日本循環器学会
学会区分	全国規模の学会
招聘	招聘
発表形式	口頭
発表者・共同発表者	◎庄田守男
発表年月日	2019/03/30
開催地 （都市, 国名）	横浜市
概要	*Meet the Expert 5 ペースメーカ感染を疑ったらすべきこと ABC Approximately 70,000 cardiac pacing devices are implanted yearly in Japan and more than 1,000 devices are infected. Cardiac pacing device infection often causes life-threatening blood stream infection and endocarditis. Therefore, early diagnosis and early treatment should be appropriately done. Diagnosis of infection is sometimes difficult because the patient may present no fever, negative CRP and negative blood culture. Correct and prompt diagnosis of localized pocket infection is a key for management of cardiac pacing device infection. After diagnosis of infection, the first-line therapy should be total removal of the entire device system and the most important treatment is lead extraction (LE). The excimer laser sheath which was a specialized tool for LE was launched in Japan 10 years ago. The number of LE cases has gradually increased after that time and now there are more than 500 LE cases annually in Japan. The present problems regarding device infection are unestablished prevention methods, under-treatment of infection. Although the guideline strongly recommends LE as the firstline therapy for device infection, there are insufficient medical centers for LE and not a few physicians are still conservative, How to diagnose and to treat the patients with cardiac pacing device infection will be discussed in this session.