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Hi everyone, this is John Mandrola from the Heart.org Medscape Cardiology and this is this week in

cardiology for December 20th 2019. This week a risk score for device infections.

Conflict of interest, fragility index, rhythm control of AFIB, and some year-end comments. Let's start with something called

the paid-it score, P-A-D-I-T.

Infection of a cardiac device is a serious problem, especially after generator changes,

because after a gen change change you have to remove chronically

into welding leads and this requires extraction which is a big deal. Now everyone

understands the basic ways to prevent infection,

sterile techniques, preoperative antibiotics,

good closure, avoiding hematoma, etc.

But an under-recognized tool in prevention of device infection

is the decision to do or not do the procedure in the first place.

And here is where a novel risk score that's designed by Canadian investigators,

led by Drs David Bernie and Andrew Kahn may help.

...