Infections Involving Cardiac Implantable Electronic Devices

Infections of cardiac implantable electronic devices (CIEDs) are an emerging problem because of increasing implant rates and comorbidities. If undiagnosed and untreated, CIED infection is associated with high mortality. Following the new guidelines concerning the use of cardiac resynchronization therapy devices in patients with congestive heart failure,1 CIED implantation has grown further. Unfortunately, this trend has been accompanied by an increase in infection rate, probably due to an increase in comorbidities. A recent analysis of US data2 showed that infection rate grew from 1.61% in 1993 to 2.41% in 2008, possibly due to two factors: ageing of population and increased use of more complex devices. Several studies3,4 have found that the most important risk factors for infection are re-intervention, with device replacement increasing with ageing of the population, and use of dual and triple chamber devices having increased over the last several years.