Cardiac Device Pocket Hematomas: The Feared Top Risk Factor for Device Infections

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The use of cardiac implantable electronic devices (CIED) has exponentially increased in recent years with an estimated 3 million pacemakers (PM) and 200,000 implantable cardioverter defibrillators (ICD) inserted annually worldwide.1 One of the most feared complications following device implantation is pocket site infections which could lead to catastrophic medical and financial consequences.2 Device pocket hematomas (PH) are well known to increase the risk of infection with the REPLACE registry demonstrating a 20-fold higher chance of developing infections.3 Post-procedural surgical pocket hematomas (PH) following CIED insertion account for approximately one quarter of all early repeat procedures post implantation.4 Many studies have been conducted in an attempt to identify modifiable mitigation strategies and periprocedural interventions to reduce the development of pocket hematomas following CIED implantation.