Cardiac device infections are associated with a significant mortality risk

Area of Science:

• Cardiology
• Infectious Diseases
• Medical Device Technology

Background:

• Cardiac device infections (CDIs) are a serious complication of cardiac rhythm device implantation.
• The impact of CDIs on long-term mortality risk remains unclear.

Purpose of the Study:

• To evaluate the prognostic significance of CDIs in patients receiving implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapy-defibrillators (CRT-Ds).

Main Methods:

• A cohort of 2476 patients who received initial ICD/CRT-D implants between 2000 and 2009 were analyzed.
• Cardiac device infections and all-cause mortality were recorded during follow-up.
• Cox proportional hazards models with CDI as a time-dependent covariate assessed mortality risk.

Main Results:

• The 3-year incidence of CDI was 2.6% in the cohort.
• A first CDI occurred in 64 patients, with a 1-year mortality rate of 16.9%.
• Experiencing a CDI was associated with a 1.87-fold increased mortality risk (HR 1.87; 95% CI 1.07-3.26), rising to a 2.40-fold increased risk (HR 2.40; 95% CI 1.35-4.28) after adjusting for confounders.

Conclusions:

• CDIs pose a substantial risk of mortality in patients with ICDs/CRT-Ds.
• Patients who develop a CDI face a significantly elevated risk of death, more than doubling their mortality risk compared to uninfected patients.