Clinical Analysis Of Cardiovascular Implantable Electronic Device Related Infection In17Cases

Objective:The purpose of this study was to analyze the risk factors and management of17patients with cardiovascular implantable electronic device the related infection in our hospital.Methods:We retrospectively reviewed17cases of cardiovascular implantable electronic device (CIED) related infection admitted to our hospital from January2009and January2013. They were followed up to March31,2014. We collected their clinical data, including basic characteristics, the type of CIED, management and outcomes, and analyse the risk factors and managments.Results:In17cases, there were10males and7females. Mean age was70.9±12.6years (range41-86years). Among patients studied,5(29.4%) had diabetes mellitus,12(70.6%) hypertension,2(11.8%) chronic kidney disease,4(23.5%) underlying heart disease (including ischemic/dilated heart disease, heart valvular disease).15(88.2%) patients of them used more than1lead.4(23.5%) had more than one device-related procedures. And among the devices, AAI was1(5.9%), WI was1(5.9%), DDD were10(58.8%) and CRT-D were5(29.4%). Removed CIED leads or pocket material or blood culture of5patients(29.4%)were positive,3staphylococcus epidermidis,1yeast-like fungi,1enterobacter cloacae. As for management, at last4underwent pocket debridement,1pacemaker transposition,1lead amputation,10transvenous lead extraction,1open lead extraction and they were without recurrence of infection during the follow-up period. And the recurrence rate after performing pocket debridement or pacemaker transposition or wire amputation was66.7%. And CIED were reimplantated in7patients (58.3%of the patients who underwent lead extraction or lead amputation).Conclusions:Factors associated with CIED infection were ages, diabetes mellitus, chronic kidney disease, underlying heart disease, type of CIED, use of>1lead and so on. The major microbial pathogen leading to CIED infection is the staphylococcus epidermidis. And once the diagnosis of CIED infection is made, complete hardware removal results in the best outcomes for patients.