Update on Cardiovascular Implantable Electronic Device Infections and Their Prevention, Diagnosis, and Management: A Scientific Statement From the American Heart Association

Abstract

The American Heart Association sponsored the first iteration of a scientific statement that addressed all aspects of cardiovascular implantable electronic device infection in 2010. Major advances in the prevention, diagnosis, and management of these infections have occurred since then, necessitating a scientific statement update. An 11-member writing group was identified and included recognized experts in cardiology and infectious diseases, with a career focus on cardiovascular infections. The group initially met in October 2022 to develop a scientific statement that was drafted with front-line clinicians in mind and focused on providing updated clinical information to enhance outcomes of patients with cardiovascular implantable electronic device infection. The current scientific statement highlights recent advances in prevention, diagnosis, and management, and how they may be incorporated in the complex care of patients with cardiovascular implantable electronic device infection.

Prevention and Risk Assessment of Cardiac Device Infections in Clinical Practice

“…Staphylococcus aureus is the leading cause of bacteremia and early CIEDs infection, and along with Gram-negatives, represents the microorganisms responsible for clinically severe infections more frequently associated with lead-related endocarditis. Several clinical studies have endeavored to identify predictive factors for CIEDs/IE in patients with Staphylococcus aureus bacteremia in the absence of pocket infection signs, such as recurrent bacteremia after an appropriate period of antibiotic therapy, persistent bacteremia for more than 24 h, presence of an ICD, prosthetic heart valve, and bacteremia within 3 months of device implantation [50].…”