Management of Cardiovascular Implantable Electronic Device Infection Utilizing a Multidisciplinary Team

Authors

• Evan Hall, University of Kentucky College of Medicine
• Bennett Collis, University of Kentucky College of Medicine
• Talal Alnabelsi, University of Kentucky
• Chloe Cao, Univ. of S. Florida Coll. of Med.
• Meredith Johnson, Univ. of Kentucky Medical Center
• John Gurley, University of KentuckyFollow
• Luke Strnad, Oregon Health and Science University
• Hassan Reda, University of Kentucky
• Tessa London, Univ. of Kentucky Medical Center
• Erinn Ogburn, Univ. of Kentucky Medical Center
• Michael Sekela, University of KentuckyFollow
• Bobbi Jo Stoner, University of Kentucky
• Sami El-Dalati, University of KentuckyFollow

Abstract

Background. Significant numbers of cardiac implantable electronic devices are placed in the United States, and infection can be a severe consequence of implantation. Despite guideline recommendations and data demonstrating that lead extraction improves mortality for patients with device infection, rates of lead removal are lower than guideline recommendations. We report the outcomes associated with management of suspected cardiac implantable electronic device infections by a multidisciplinary team. Methods. Patient cases were identified from an institutional multidisciplinary endocarditis team registry in a single-center retrospective study. Demographic, treatment, and outcomes data were recorded by study investigators. Results. Between September 7, 2021, and February 1, 2024, 80 consecutive patients with suspected cardiac implantable electronic device infections were identified. Fifty-four (67.5%) patients, including 27/35 (77.1%) with definitive device infection/endocarditis and 30/30 (100%) with pocket infections, underwent device removal at a median of 3 days after admission to the authors’ institution. In-hospital and 90-day mortality was numerically lower in patients who underwent device removal compared with those who did not (13% vs 19.2%; P = .47 and 22.2% vs 38.5%; P = .13), and 1-year mortality was significantly lower for patients who underwent device removal (34% vs 70.1%; P = .01). Only 48.1% of patients had a device replaced during the study period. Conclusions. The use of a multidisciplinary team for management of suspected cardiac implantable electronic device infections was associated with high rates of expedient device extraction and relatively low rates of device reimplantation. One-year mortality was lower in patients who underwent device extraction.

Document Type

Article

Publication Date

4-1-2025

Notes/Citation Information

Publisher Copyright: © The Author(s) 2025. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

Digital Object Identifier (DOI)

10.1093/ofid/ofaf148

Archival?

Archival

Repository Citation

Hall, Evan; Collis, Bennett; Alnabelsi, Talal; Cao, Chloe; Johnson, Meredith; Gurley, John; Strnad, Luke; Reda, Hassan; London, Tessa; Ogburn, Erinn; Sekela, Michael; Stoner, Bobbi Jo; and El-Dalati, Sami, "Management of Cardiovascular Implantable Electronic Device Infection Utilizing a Multidisciplinary Team" (2025). Surgery Faculty Publications. 89.
https://uknowledge.uky.edu/surgery_facpub/89