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Published on: February 28, 2012
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Diagnosis and management of infections involving implantable electrophysiologic cardiac devices
1Department of Infectious Disease, S32, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Annals of Internal Medicine
|October 18, 2000
Summary
Complete removal of infected implantable cardiac devices and antibiotic treatment are effective. This approach allows for successful reimplantation without significant operative risk or infection recurrence.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Device Technology
Background:
- Infections associated with implantable electrophysiologic cardiac devices lack defined optimal treatment strategies.
- Understanding clinical presentation, management, and outcomes is crucial for patient care.
Purpose of the Study:
- To describe the clinical presentation, treatment, and outcomes of patients with infections involving implantable electrophysiologic cardiac devices.
- To evaluate the efficacy of device removal and antimicrobial therapy.
Main Methods:
- Retrospective case series of 123 patients with device infections.
- Data collected included demographics, clinical manifestations, diagnosis time, management, and outcomes.
- Analysis of infection characteristics and treatment effectiveness.
Main Results:
- Coagulase-negative staphylococci and Staphylococcus aureus were the most common pathogens.
- Complete device extraction (95%) and a median of 28 days of antibiotic therapy were employed.
- Operative mortality was zero, with crude mortality and relapse rates of 8% and 3%, respectively.
Conclusions:
- Complete device removal and antimicrobial therapy are effective for treating implantable cardiac device infections.
- Successful reimplantation at a remote site is feasible without substantial operative risk or recurrent infection.
- This strategy ensures timely and safe management of device-related infections.
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