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CIED infection with either pocket or systemic infection presentation--complete device removal and long-term

Nikolaj Ihlemann1, Michael Møller-Hansen1, Kirsten Salado-Rasmussen2

  • 1a Department of Cardiology , The Heart Centre, University Hospital of Copenhagen, Rigshospitalet , Denmark .

Scandinavian Cardiovascular Journal : SCJ
|October 21, 2015
PubMed

Insights

Cardiovascular implantable electronic device (CIED) infections present similarly and have comparable outcomes. Complete device removal and prolonged antibiotic treatment are safe and effective for CIED infections, preventing relapses.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Device Technology

Background:

  • Cardiovascular implantable electronic device (CIED) infections are a growing concern.
  • Distinguishing between local pocket and systemic CIED infections can be challenging.

Purpose of the Study:

  • To review the clinical presentation and outcomes of patients with CIED infections.
  • To compare outcomes between systemic and local pocket CIED infections.

Main Methods:

  • Retrospective review of 71 CIED removals due to infection between 2005 and 2012.
  • Infections categorized as systemic or pocket infections.
  • Treatment involved complete device removal and six weeks of antibiotics.

Main Results:

  • No significant difference in long-term mortality between pocket and systemic CIED infections.
  • 30-day mortality was 4%, and 12-month mortality was 14%.
  • Low relapse rate (2.8%) with no long-term differences in mortality.

Conclusions:

  • Clinical presentation and outcomes of systemic and pocket CIED infections are difficult to differentiate.
  • Complete CIED removal with extended antibiotic therapy is a safe and effective treatment strategy.
  • This approach demonstrated no relapses in the study cohort.
Abstract

Keywords:
CIED infectionantibiotic regimenlong-term follow-up

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