Incidence and risk factors of pacemaker pocket infection - an observational study

Area of Science:

• Cardiology
• Infectious Diseases
• Medical Device Research

Background:

• Cardiac Implantable Electronic Devices (CIEDs), including permanent pacemakers (PPMs), are crucial for managing cardiac arrhythmias.
• PPM infections (PPMI) represent a significant complication, necessitating a thorough understanding of associated risk factors and causative agents.
• Identifying trends in PPM implantation and infection profiles is vital for improving patient outcomes and device management strategies.

Purpose of the Study:

• To analyze the indications for PPM implantation.
• To identify risk factors, demographic characteristics, and microbiological profiles associated with PPM infections (PPMI).
• To determine the incidence and characteristics of PPMI in a hospital-based cohort.

Main Methods:

• Retrospective, hospital-based observational study design.
• Inclusion of 716 patients who underwent CIED implantation, with a focus on those presenting with local inflammatory signs.
• Exclusion of patients under 18 years of age.

Main Results:

• A total of 716 patients underwent CIED implantation; 37.7% received single-chamber and 52.8% received double-chamber devices.
• PPMI was diagnosed in 15 patients (2.09%), with a higher prevalence in devices implanted over 12 months prior.
• Common comorbidities were diabetes (36.11%) and hypertension (32.56%). Culture-negative infections (53.33%) and methicillin-resistant Staphylococcus aureus (MRSA) (33.33%) were the predominant microbiological findings.

Conclusions:

• PPM infections are a notable complication, particularly in devices with longer implantation durations.
• Diabetes and hypertension are significant comorbidities associated with PPMI.
• The microbiological landscape of PPMI is characterized by a high rate of culture-negative infections and the presence of MRSA, guiding empirical treatment strategies.