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Infective Endocarditis After Arrythmia Device Implantation in Cardiac Surgery Patients.
Andreas Martinsson1,2, Sigurdur Thorleifsson1,2, Alice David1,2
1Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden.
Journal of the American Heart Association
|March 13, 2026
Summary
Implanting cardiac devices after heart surgery increases infective endocarditis (IE) risk and mortality. Risk factors include surgery type and patient health.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Devices
Background:
- Cardiac surgery patients have elevated infective endocarditis (IE) risk.
- Cardiac implantable electronic devices (CIEDs) may further increase IE risk in these patients.
Purpose of the Study:
- To evaluate the risk of IE following CIED implantation within 30 days of cardiac surgery.
- To identify risk factors associated with IE in this patient population.
Main Methods:
- Nationwide registry study in Sweden (2006-2020) including first-time cardiac surgery patients without prior CIEDs.
- Cox proportional hazards models were used to analyze the association between CIED implantation and IE risk, adjusting for covariates.
Main Results:
- 3.1% of 73,367 patients received a CIED within 30 days post-surgery.
- CIED implantation was linked to a 46% increased IE risk (aHR, 1.46).
- IE significantly increased mortality risk (aHR, 1.80); valvular surgery and comorbidities like diabetes were associated with higher IE incidence.
Conclusions:
- CIED implantation shortly after cardiac surgery elevates long-term IE and mortality risks.
- The type of cardiac surgery and patient comorbidities are significant factors influencing IE risk.
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