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Long-term outcomes following infection of cardiac implantable electronic devices: a prospective matched cohort study

Jean-Claude Deharo1, Amandine Quatre, Julien Mancini

  • 1Cardiology Department, CHU La Timone, Medical School of Marseilles, Marseilles, France. jean-claude.deharo@ap-hm.fr

Heart (British Cardiac Society)
|April 24, 2012
PubMed

Insights

Cardiac implantable electronic device (CIED) infections treated with current recommendations show similar long-term mortality to uninfected patients. Key mortality predictors include age, specific therapies, and comorbidities.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Device Technology

Background:

  • Cardiac implantable electronic device (CIED) infections pose significant risks.
  • Current treatment guidelines aim to improve outcomes for CIED infections.

Purpose of the Study:

  • To evaluate long-term mortality and identify predictors in patients treated for CIED infections according to current standards.
  • To compare outcomes of infected CIED patients with a matched cohort of uninfected patients.

Main Methods:

  • A matched cohort study involving 197 patients with CIED infections and 197 controls.
  • Infected patients underwent hardware removal, antimicrobial therapy, and device reimplantation if necessary.
  • Systematic follow-up assessed all-cause mortality and its predictors.

Main Results:

  • Long-term mortality rates at 1 and 5 years were comparable between infected and uninfected CIED patients (35.4% vs 27.0% at 5 years).
  • Independent predictors of mortality included older age, cardiac resynchronization therapy, thrombocytopenia, and renal insufficiency.
  • Reimplanted epicardial right ventricular pacemakers were associated with increased mortality.

Conclusions:

  • Recommended therapy for CIED infections results in long-term mortality comparable to uninfected individuals.
  • Patient-related factors and specific device choices, like epicardial pacemakers, are crucial predictors of mortality.
Abstract

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