Permanent Pacemaker and Implantable Cardioverter Defibrillator Infections: Seven Years of Diagnostic and Therapeutic Experience of a Single Center

Abstract

Background: Increasing evidence-based indications for the implantation of permanent pacemakers (PMs) and implantable cardioverter defibrillators (ICDs) have led to an increase in the rate of device infections. The aim of the present study was to evaluate infection frequency, clinical characteristics, risk factors, and microbiologic and therapeutic features in patients with PM/ICD infections. Hypothesis: Clinical and demographic characteristics of the patients can affect the PM/ICD infections. Methods: The PM/ICD infection group consisted of 57 patients diagnosed and treated with PM/ICD infections in our hospital. The control group in this case-control study consisted of 833 patients in whom a PM or ICD had been implanted and no infections were noted. Results: Patients with PM/ICD infections (median age 65 years; range, 18-104 years) were older than those without PM/ICD infections (median age 58 years; range, 18-86 years; P = 0.005). The percentage of generator replacement was higher in the PM/ICD infection group compared with the control group (16% vs 8%, P = 0.003). Independent predictors of PM/ICD infections were advanced age (>60 years; odds ratio [OR]: 2.5, 95% confidence interval [CI]: 1.2-4.0, P = 0.021) and device revision (OR: 3.8, 95% CI: 1.5-5.5, P = 0.002). Primary antibiotic prophylaxis during the procedure reduced the risk for PM/ICD infection (OR: 0.5, 95% CI: P = 0.011). Conclusions: PM/ICD infections occur in a significant number of patients. It is important to be aware of the risk factors for PM/ICD infections so that patients with an increased risk can be identified and preventive measures can be implemented.