Management of Cardiovascular Implantable Electronic Device Infection Utilizing a Multidisciplinary Team: A...

Area of Science:

• Cardiology
• Infectious Diseases
• Medical Device Management

Background:

• Cardiac implantable electronic devices (CIEDs) are widely used, but infections pose a severe risk.
• Despite guidelines, CIED lead extraction rates for infected devices remain suboptimal.
• Multidisciplinary team (MDT) management offers a potential solution for CIED infections.

Purpose of the Study:

• To evaluate the outcomes of managing suspected CIED infections using an MDT approach.
• To assess the impact of MDT management on device extraction rates and patient mortality.
• To analyze the effectiveness of timely intervention in improving survival for CIED infections.

Main Methods:

• Retrospective study of 80 patients with suspected CIED infections identified from an institutional MDT registry.
• Data collection included demographics, treatments, and patient outcomes.
• Comparison of outcomes between patients who underwent device removal and those who did not.

Main Results:

• 67.5% of patients underwent device removal, with high rates in definitive device infection (77.1%) and pocket infections (100%).
• Device removal was associated with numerically lower in-hospital and 90-day mortality.
• One-year mortality was significantly lower for patients who underwent device removal (34% vs. 70.1%, P = .01).

Conclusions:

• MDT management facilitates high rates of prompt CIED extraction.
• Device extraction is linked to reduced one-year mortality in patients with CIED infections.
• Device reimplantation rates were relatively low during the study period.