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Cardiac device infections are associated with a significant mortality risk

Mihály K de Bie1, Johannes B van Rees, J Thijssen

  • 1Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.

Heart Rhythm
|November 8, 2011
PubMed

Insights

Cardiac device infections (CDIs) significantly increase mortality risk in patients with implantable cardioverter-defibrillators or cardiac resynchronization therapy-defibrillators. Experiencing a CDI more than doubles the risk of death compared to those without infection.

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.
Abstract

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