Accurate diagnosis of cardiovascular implantable electronic device infections requires a combination of physical examination, microbiological and laboratory testing, and advanced imaging.
This review outlines an evidence-based approach to accurately diagnosing CIED infections using a combination of physical examination, microbiological testing, and advanced imaging.
Device infection remains a significant challenge as clinical indications for cardiovascular implantable electronic device (CIED) therapy continue to expand beyond the prevention and treatment of cardiac arrhythmias. Patients receiving CIED therapy are now older and have significant comorbidities, placing them at higher risk of complications, including infection. CIED infection warrants complete device removal, as retention is associated with an unacceptably high risk of relapse and increased mortality. However, accurate diagnosis of CIED infections remains a significant challenge that is based on a combination of findings on physical examination, microbiological and laboratory testing, and advanced imaging, such as transesophageal echocardiography or positron emission tomography. Isolating a causative pathogen and performing susceptibility testing are crucial for appropriate choice, route, and duration of antimicrobial therapy. In this review, we present an evidence-based approach to diagnosis of CIED infection.
DeSimone et al. (Tue,) conducted a review in Cardiovascular Implantable-Electronic-Device (CIED) Infection. Diagnostic approach (physical examination, microbiological testing, advanced imaging) was evaluated. Accurate diagnosis of cardiovascular implantable electronic device infections requires a combination of physical examination, microbiological and laboratory testing, and advanced imaging.