Key result
CIED infections occur in ~2% of replacements and necessitate prompt diagnosis and device removal.
Prompt diagnosis, antibiotic therapy, device removal, and strict sterile techniques are essential for managing and preventing CIED infections, which occur in 0.5-2% of procedures.
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Clinicians must remain vigilant given persistent infection rates; this review leaves open questions on reducing replacement-associated risk.
Increasing numbers of patients with cardiac disease have improved quality of life and longevity as a result of cardiac implantable electronic devices (CIEDs). CIED infections can involve the generator pocket, bloodstream, or cardiac structures and occur in about 0.5% of de novo CIED implants and approximately 2% of CIED replacements. Prompt diagnosis of CIED infection is beneficial to the success of antibiotic therapy and subsequent device removal to resolve the infection. Measures to prevent CIED infections include assessment of the indication and patient status, strict sterile surgical techniques, preoperative antibiotics, and adequate homeostasis. New surgical methods and CIED devices may also lead to reduction in CIED infections. Further research is needed to better quantify the incidence of CIED, risk factors, and efficacy of surgical techniques to prevent infections.
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Lambert et al. (2017) conducted a review in Cardiac implantable electronic device (CIED) infection. Cardiac implantable electronic device (CIED) infections occur in approximately 0.5% of de novo implants and 2% of replacements, necessitating prompt diagnosis and device removal.
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