Infections of electrophysiologic cardiac devices

Infections related to electrophysiologic cardiac device placement are increasing dramatically and are associated with adverse outcomes. With the US population aging and living longer, cardiac devices are utilized in an older population with significant comorbidities, making the threat from infectious complications significant. Electrophysiologic cardiac devices typically include an implanted pulse generator and an intravascular lead. Infection may occur at any component of the device, resulting in varied presentations. Bacteremia in cardiac device recipients may reflect primary generator pocket infection, or alternate sources of bacteremia may result in secondary hematogenous lead infection. This review focuses on the pathology, diagnosis, management and prevention of electrophysiologic cardiac device infections.