The Infections of Cardiac Implantable Electronic Devices: Four Year Experience of a Single Center

Abstract

years. The incidence of infection has ranged from 0.5 % to 12% in the literature. The purposes

of this study was to investigate the frequency of CIED infection and to find the causes of

infection.

Patients and methods: Totally, 211 patients with CIED infection were retrospectively evaluated.

For each patient, all the following data were recorded; age, sex, CIED type, accompanying

diseases, complete blood count, serum biochemistry, echocardiographic findings and whether

first implantation or replacement. In addition, wound culture, antibiotic regime, erythrocyte

sedimentation rate (ESR), C-reactive protein (CRP), glomerular filtration rate (GFR) and

anticoagulation test results were recorded in infected patients.

Results: CIED infection was detected in 18 of the 211 patients (8.5%). 15 cases developed

infection following the first implantation (10%), and 3 cases after replacement (5%). Infection

was detected within 60 days in 5 patients. CIED pocket cultures were positive in 12 patients

(66.7%). 13 of 18 infected devices were removed (72.2%). Diabetes mellitus [Odds Ratio, OR:

4.56 (1.449-14.408)] (p=0.010), male sex [OR: 3.84 (1.034-14.232)] (p=0.045) and increasing age

[OR: 0.96 (0.932-0.998)] (p=0.038) were found as significant independent variables on

development of CIED; but, pacemaker, implantable cardioverter defibrillator and cardiac

resynchronization were not independent variables [OR: 1.66 (0.469-5.929)] (p=0.43).

Conclusions: Increasing age, male sex, diabetes mellitus were related to increased frequency

of CIED infections. Identification of comorbid conditions prior to CIED implantations may be

important in reducing risk of CIED infections.

Keywords

• Cardiac Implantable Electronic Devices,Staphylococcus Epidermidis,Infection

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