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Cardiac implantable electronic device and associated risk of infective endocarditis in patients undergoing aortic

Lauge Østergaard1, Nana Valeur2, Henning Bundgaard1

  • 1The Heart Center, Rigshospitalet, Blegdamsvej 9, Copenhagen, Denmark.

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
|January 3, 2018
PubMed

Insights

Patients with cardiac implantable electronic devices (CIED) undergoing aortic valve replacement (AVR) face a higher risk of infective endocarditis (IE). This increased risk of IE was observed regardless of when the CIED was implanted relative to AVR surgery.

Area of Science:

  • Cardiovascular Surgery
  • Infectious Diseases
  • Biomedical Engineering

Background:

  • Patients undergoing aortic valve replacement (AVR) have an elevated risk of infective endocarditis (IE).
  • Patients with cardiac implantable electronic devices (CIED) also face an increased risk of IE.
  • Limited data exist on the combined risk of IE following AVR in patients with CIEDs.

Purpose of the Study:

  • To investigate the risk of IE in patients who have undergone AVR surgery and have a CIED.
  • To determine if the timing of CIED implantation (before or during AVR) influences IE risk.

Main Methods:

  • Retrospective cohort study using Danish administrative registries (1996-2015).
  • Identified 15,538 patients undergoing AVR, categorized by CIED presence (n=890) and absence (n=14,648).
  • Utilized multivariable-adjusted Cox proportional hazard analysis to assess IE risk.

Main Results:

  • The crude incidence rate of IE was higher in the CIED group (149.4/10,000 person-years) compared to the non-CIED group (74.3/10,000 person-years).
  • CIED was significantly associated with an increased risk of IE (Hazard Ratio: 1.66; 95% CI: 1.27-2.17).
  • No significant difference in IE risk was found based on the timing of CIED implantation relative to AVR.

Conclusions:

  • Patients with CIEDs undergoing AVR surgery have a significantly higher risk of developing IE.
  • This increased IE risk associated with CIEDs is independent of whether the device was implanted before or concurrently with AVR surgery.
Abstract

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