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Risk of Cardiovascular Implantable Electronic Device Infection in Patients With Cardiac Sarcoidosis
Chukwuka Ibecheozor1, Jonathon Mitchell2, Chloe Duvall3
1Department of Medicine, Division of Cardiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Journal of Cardiovascular Electrophysiology
|February 23, 2026
Summary
Immunosuppression therapy did not increase the risk of cardiovascular implantable electronic device (CIED) infections in cardiac sarcoidosis patients. This finding supports current management strategies for these complex patients.
Area of Science:
- Cardiology
- Immunology
- Infectious Disease
Background:
- Cardiac sarcoidosis (CS) management often involves immunosuppressive therapy concurrently with cardiovascular implantable electronic device (CIED) implantation.
- The potential for increased infection risk with combined immunosuppression and CIED procedures in CS patients is not well-established.
- Determining the safety of immunosuppression during CIED implantation is crucial for optimizing patient care.
Purpose of the Study:
- To investigate the association between immunosuppressive therapy and CIED-related infections in patients diagnosed with cardiac sarcoidosis.
- To evaluate the incidence of CIED pocket infections and bloodstream infections (BSIs) in relation to immunosuppression status at the time of device implantation.
Main Methods:
- A retrospective review was conducted on biopsy-proven CS patients who received a CIED at a tertiary care center.
- Data on CIED type, procedural history, antibiotic envelope use, and immunosuppressive regimen at implantation were collected.
- The primary outcome assessed was the occurrence of CIED pocket infection or BSI during follow-up.
Main Results:
- The study included 175 CS patients, with 70 on immunosuppressive therapy at CIED implantation.
- No significant difference in CIED-related infection rates (pocket infection or BSI) was observed between patients on immunosuppression versus those not on immunosuppression (p=0.90).
- Two pocket infections occurred, unrelated to immunosuppression status at implantation, and were linked to multiple prior CIED procedures.
Conclusions:
- In cardiac sarcoidosis patients undergoing CIED implantation, immunosuppressive therapy at the time of the procedure is not associated with an elevated risk of device-related infections.
- Current management strategies involving concurrent immunosuppression and CIED implantation appear safe regarding infection risk in this population.
- Further research may explore specific immunosuppressive agents and their impact on infection risk in CS patients.
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