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Temporal and Microbiological Analysis of Cardiac Implantable Electrical Device Infections　- A Retrospective Study

Yasuo Miyagi1, Shun-Ichiro Sakamoto1, Yasuhiro Kawase1

  • 1Department of Cardiovascular Surgery, Nippon Medical School Tokyo Japan.

Circulation Reports
|September 27, 2021
PubMed

Insights

Cardiac implantable electronic device (CIED) infections peak within the first year post-implantation, with most occurring within five years. Staphylococcal infections are common, and infection patterns vary by clinical presentation and pathogen pathway.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Device Technology

Background:

  • Cardiac implantable electronic device (CIED) infections are a significant concern.
  • While causative pathogens are known, the temporal patterns of CIED infections require further investigation.

Purpose of the Study:

  • To investigate the microbiology and onset of CIED infections based on infection patterns.
  • To analyze the relationship between time after CIED implantation and infection characteristics.

Main Methods:

  • Retrospective study of 97 patients undergoing CIED removal due to infection (April 2009 - December 2018).
  • Categorization of infections into systemic (SI) vs. local (LI) and pocket-related (PR) vs. non-pocket-related (non-PR).
  • Analysis of pathogen types and temporal distribution relative to implantation time.

Main Results:

  • CIED infections peaked in the first year post-implantation, declining over 10 years, with over 60% occurring within 5 years.
  • Staphylococcal infections predominated throughout the study period.
  • Systemic infections were mainly caused by *Staphylococcus aureus*, while local infections were associated with coagulase-negative staphylococci. Both SI and LI peaked early.
  • Non-pocket-related infections showed a uniform temporal distribution after the first year, unlike pocket-related infections.

Conclusions:

  • The temporal distribution of CIED infections is influenced by the microbiological intrusion pathway.
  • Infection severity is linked to the causative pathogen, while timing relates to how the pathogen enters the system.
Keywords:
DevicesEndocarditisInfection

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