Approach to diagnosis of cardiovascular implantable-electronic-device infection

Daniel C. DeSimone, M. Rizwan Sohail

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Device infection remains a significant challenge as clinical indications for cardiovascular implantable electronic device (CIED) therapy continue to expand beyond the prevention and treatment of cardiac arrhythmias. Patients receiving CIED therapy are now older and have significant comorbidities, placing them at higher risk of complications, including infection. CIED infection warrants complete device removal, as retention is associated with an unacceptably high risk of relapse and increased mortality. However, accurate diagnosis of CIED infections remains a significant challenge that is based on a combination of findings on physical examination, microbiological and laboratory testing, and advanced imaging, such as transesophageal echocardiography or positron emission tomography. Isolating a causative pathogen and performing susceptibility testing are crucial for appropriate choice, route, and duration of antimicrobial therapy. In this review, we present an evidence-based approach to diagnosis of CIED infection.

Original languageEnglish (US)
JournalJournal of clinical microbiology
Volume56
Issue number7
DOIs
StatePublished - Jul 2018

Keywords

  • CIED infection
  • Diagnosis
  • ICD
  • Pacemaker

ASJC Scopus subject areas

  • Microbiology (medical)

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