Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2019, vol. 28, nr 2, February, p. 263–270

doi: 10.17219/acem/80665

Publication type: review

Language: English

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Infections of cardiac implantable electronic devices: Epidemiology, classification, treatment, and prognosis

Grzegorz Sławiński1,A,B,C,D,E,F, Ewa Lewicka1,A,B,C,D,E,F, Maciej Kempa1,A,B,C,D,E,F, Szymon Budrejko1,A,B,C,D,E,F, Grzegorz Raczak1,A,B,C,D,E,F

1 Department of Cardiology and Electrotherapy, Medical University of Gdańsk, Poland

Abstract

The increasing number of implantation procedures of implantable cardiac electronic devices (ICEDs) leads to a substantial growth of a cohort of patients in whom complications of such a therapy occur. Infective complications are among the most severe ones, as they are often associated with poor prognosis. Depending on the criteria applied, the incidence of cardiac device infection (CDI) is estimated at 0.5–2.2%. Many risk factors of CDIs have been identified, among which the most important are numerous previous cardiac electrotherapy procedures and their complexity, and the lack of perioperative antibiotic prophylaxis. Appropriate diagnosis of a suspected CDI is of utmost importance, as well as the correct classification of the infection, which leads to adequate treatment. Management of a CDI should include complete removal of the implanted device. Additionally, empirical and then targeted antibiotic therapy should be instituted. The prognosis of CDI may, nonetheless, be unfavorable. Despite appropriate treatment, the total mortality rate of such complication is estimated to be as high as 35%.

Key words

infective endocarditis, implantable cardioverter-defibrillator, implantable cardiac electronic device, cardiac pacemaker, infective complications

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