Cardiac Implantable Electronic Device Infections at a Tertiary Center in Southern Chile (2015-2021): A Retrospective...

Cardiac implantable electronic device (CIED) infections are infrequent but clinically significant, and Latin American-particularly Chilean-data remain scarce. We aimed to describe the clinical and microbiological profile, complications, mortality, and local infection burden of CIED infections at a tertiary center in southern Chile.

This was a retrospective descriptive cohort study of all patients treated for CIED infection at Hospital Dr. Hernán Henríquez Aravena between January 2015 and December 2021. Crude per-procedure infection proportions were calculated using locally implanted devices (primary implants, generator replacements, and upgrades) as the denominator; because annual implant volumes and individual follow-up times were not retrievable, only exploratory approximate rates per 100 patient-years were derived under strong assumptions and were not used for formal comparison.

Fifty-four patients were included (77.8% men; mean age 69 ± 14 years). Predominant comorbidities were arterial hypertension (79.6%), heart failure (40.7%), atrial fibrillation (27.8%), and type 2 diabetes mellitus (24.1%). Pacemakers accounted for 59.3% of infections, and late-onset cases predominated (48.2%). The overall per-procedure infection proportion was 1.4% (95% confidence interval [CI] 1.1-1.9%) and was numerically higher for implantable cardioverter-defibrillators (ICDs; 5.5%) and cardiac resynchronization therapy (CRT) devices (4.3%) than for pacemakers (1.1%). Coagulase-negative Staphylococcus (43.2%) and Staphylococcus aureus (24.3%) were the leading isolates, although microbiological sampling was incomplete (available in 68.5%). Complete system extraction was attempted in all patients and achieved in all but one case; recurrence occurred in 9.3% and in-hospital mortality in 1.9%.

The clinical and microbiological profile of CIED infections in this single-center southern Chilean cohort was broadly consistent with international series. Per-procedure proportions for ICDs and CRT devices were numerically higher than those for pacemakers, but the retrospective design, a procedure-based denominator including replacements and upgrades, and incomplete echocardiographic and microbiological workup preclude formal comparison with time-to-event registries; these device-specific findings should be regarded as exploratory and hypothesis-generating. The findings identify concrete, locally actionable targets: more systematic microbiological sampling, broader pre-procedural and diagnostic echocardiography (including transesophageal studies), and strengthened long-term follow-up of CIED carriers.