Key result
Device removal occurs in ~91% of CDRIE cases, mostly percutaneously, though heart failure remains a common complication.
Why the study?
The rate of cardiac device-related infective endocarditis is increasing worldwide, but detailed data were lacking for Poland.
Observational (n=195)
Yes
The management of CDRIE in Poland aligns with European data, though transesophageal echocardiography is underutilized compared to recommendations.
Polish CDRIE profiles align with European data; supports uniform management protocols but leaves open need for outcome-focused trials.
BACKGROUND: The rate of cardiac device-related infective endocarditis (CDRIE) is increasing worldwide, but no detailed data are available for Poland. AIMS: We aimed to evaluate clinical, diagnostic, and therapeutic data of patients hospitalized due to CDRIE in 22 Polish referential cardiology centers from May 1, 2016 to May 1, 2017. METHODS: Participating cardiology departments were asked to fill in a questionnaire that included data on the number of hospitalized patients, number and types of implanted cardiac electrotherapy devices, and number of infective endocarditis cases. We also collected clinical data and data regarding the management of patients with CDRIE. RESULTS: Overall, 99 621 hospitalizations were reported. Infective endocarditis unrelated to cardiac device was the cause of 596 admissions (0.6%), and CDRIE, of 195 (0.2%). Pacemaker was implanted in 91 patients with CDRIE (47%); cardioverter‑defibrillator, in 51 (26%); cardiac resynchronization therapy‑defibrillator, in 48 (25%); and cardiac resynchronization therapy‑pacemaker, in 5 (2.5%). The most common symptoms were malaise (62%), fever/chills (61%), cough (21%), chest pain (19.5%), and inflammation of the device pocket (5.6%). Cultures were positive in 77.5% of patients. The cardiac device was removed in 91% of patients. The percutaneous approach was most common for cardiac device removal. All patients received antibiotic therapy, and 3 patients underwent a heart valve procedure. Transesophageal echocardiography was performed in 80% of patients. The most common complication was heart failure (25% of patients). CONCLUSIONS: The clinical profile, pathogen types, and management strategies in Polish patients with CDRIE are consistent with similar data from other European countries. Transesophageal echocardiography was performed less frequently than recommended. The removal rate in the Polish population is consistent with the general rates observed for interventional treatment in patients with CDRIE.
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Płońska‐Gościniak et al. (2019) conducted an observational in Cardiac device-related infective endocarditis (CDRIE) (n=195). Cardiac device-related infective endocarditis was evaluated on Clinical, diagnostic, and therapeutic characteristics. Among 195 patients with cardiac device-related infective endocarditis in Poland, 91% underwent device removal, mostly percutaneously, and 25% experienced heart failure as a complication.
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