Language
English
Publication Date
4-4-2023
Journal
Journal of the American College of Cardiology
DOI
10.1016/j.jacc.2023.01.038
PMID
36990548
Abstract
Infection remains a serious complication associated with the cardiac implantable electronic devices (CIEDs), leading to substantial clinical and economic burden globally. This review assesses the burden of cardiac implantable electronic device infection (CIED-I), evidence for treatment recommendations, barriers to early diagnosis and appropriate therapy, and potential solutions. Multiple clinical practice guidelines recommended complete system and lead removal for CIED-I when appropriate. CIED extraction for infection has been consistently reported with high success, low complication, and very low mortality rates. Complete and early extraction was associated with significantly better clinical and economic outcome compared with no or late extraction. However, significant gaps in knowledge and poor recommendation compliance have been reported. Barriers to optimal management may include diagnostic delay, knowledge gaps, and limited access to expertise. A multipronged approach, including education of all stakeholders, a CIED-I alert system, and improving access to experts, could help bring paradigm shift in the treatment of this serious condition.
Keywords
Humans, Defibrillators, Implantable, Delayed Diagnosis, Heart Diseases, Device Removal, Pacemaker, Artificial, Prosthesis-Related Infections, CIED, barriers, extraction, infection, structured literature review, treatment guidelines
Published Open-Access
yes
Recommended Citation
Lakkireddy, Dhanunjaya R; Segar, Douglas S; Sood, Ami; et al., "Early Lead Extraction for Infected Implanted Cardiac Electronic Devices: JACC Review Topic of the Week" (2023). Faculty and Staff Publications. 4658.
https://digitalcommons.library.tmc.edu/baylor_docs/4658