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Outcomes in patients undergoing cardiac resynchronisation therapy complicated by device-related infective

Ewa Jędrzejczyk-Patej1, Michał Mazurek, Oskar Kowalski

  • 1Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Centre for Heart Diseases, Zabrze, Poland. ewajczyk@op.pl.

Kardiologia Polska
|August 10, 2018
PubMed

Insights

Cardiac device-related infective endocarditis (CDRIE) is a serious complication of cardiac resynchronisation therapy (CRT). Early device removal significantly reduces mortality in CRT patients with CDRIE.

Area of Science:

  • Cardiology
  • Infectious Diseases

Background:

  • Cardiac device-related infective endocarditis (CDRIE) is a severe complication of cardiac resynchronisation therapy (CRT).
  • Assessing outcomes in CRT patients with CDRIE is crucial for improving patient management.

Purpose of the Study:

  • To evaluate clinical outcomes in patients with CRT who develop CDRIE.
  • To identify factors influencing mortality in CRT patients with CDRIE.

Main Methods:

  • A retrospective analysis of 765 CRT implantations between 2002 and 2015.
  • CDRIE cases were identified using modified Duke criteria.
  • Clinical outcomes and mortality predictors were assessed through multivariate regression analysis.

Main Results:

  • CDRIE was diagnosed in 5.4% of CRT patients, with a high overall mortality rate (75.6%).
  • Device explantation was associated with significantly lower in-hospital mortality (39.3% vs. 76.9%, p=0.025).
  • Independent predictors of mortality included need for temporary pacing, delayed device removal (>7 days), and acute kidney injury.

Conclusions:

  • Device removal is independently associated with reduced mortality in CRT patients with CDRIE.
  • Early device removal, absence of need for temporary pacing post-explantation, and normal renal function are associated with better outcomes.
Abstract

Keywords:
cardiac resynchronization therapydevice-related infective endocarditisheart failuremortality predictors

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