Cardiac implantable electronic device infection: prevalence and risk factors

Background: The number of cardiac implantable electronic device implantation procedures has increased dramatically in recent decades due to population aging and expansion of indications. At the same time, the number of cardiac implantable electronic device associated complications has increased too. Infection is a very important and heavy complication of cardiac implantable electronic device implantation, which significantly increases mortality and morbidity. This study aimed to estimate the risk of cardiac implantable electronic device infection in a group of patients who received an aggressive scheme of postoperative antibiotic therapy and compare this with the risk of infection in another group, where a mild antibiotic therapy scheme was used. Methods: A retrospective, observational study was performed. The study sample included 355 patients. Two antibiotic prophylaxis and wound follow-up protocols (mild and aggressive) were used. In this study the effectiveness of both methods to prevent a cardiac implantable electronic device related infection was compared. Results: The prevalence of infection was 3.5% in the group with mild scheme and 1.13% in the group with the aggressive scheme. The difference in two subgroups was not significant ( p=0,149). According to this study severe renal failure, chronic obstructive pulmonary disease and thyroid dysfunction were found as significant predictors for having cardiac implantable electronic device infection. In participants who underwent a reimplantation and in those with postoperative hematoma the odds of having infection was higher, compared to patients with primary implantation and absence of hematoma. Age of participants with cardiac implantable electronic device infection was younger compared to patients without infection. Conclusion: According to this study there is no statistically significant difference on cardiac implantable electronic device infection between mild and aggressive antibiotic therapy schemes.