Key result
Leadless pacemakers, antibacterial envelopes, and subcutaneous ICDs effectively reduce CIED infection risk and mortality.
May guide device selection in high-risk patients; leaves open confirmation by randomized trials.
There has been a significant increase in the number of patients receiving cardiovascular implantable electronic devices (CIED) over the last two decades. CIED infection represents a serious complication after CIED implantation and is associated with significant morbidity and mortality. Recently, newly advanced technologies have offered attractive and suitable therapeutic alternatives. Notably, the leadless pacemaker and anti-bacterial envelope decrease the potential risk of CIED infection and the resulting mortality, when it does occur. A completely subcutaneous implantable cardioverter defibrillator is also an alternative to the transvenous implantable cardioverter defibrillator (ICD), as it does not require implantation of any transvenous or epicardial leads. Among the patients who require ICD removal and subsequent antibiotics secondary to infection, the wearable cardioverter defibrillator represents an alternative approach to inpatient monitoring for the prevention of sudden cardiac death. In this review paper, we aimed to introduce the advanced technologies and devices for prevention of CIED infection.
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Kondo et al. (2016) conducted a review in Cardiac implantable electronic device (CIED) infection. Infection prevention technologies (leadless pacemakers, anti-bacterial envelopes, S-ICD, WCD) vs. Conventional transvenous CIEDs was evaluated. Advanced technologies including leadless pacemakers, anti-bacterial envelopes, subcutaneous ICDs, and wearable cardioverter defibrillators provide effective alternatives to reduce the risk of CIED infections and associated mortality.