Cardiac Implantable Electronic Devices Infection Assessment, Diagnosis and Management: A Review of the Literature
The use of increasingly complex cardiac implantable electronic devices (CIEDs) has increased exponentially in recent years. One of the most serious complications in terms of mortality, morbidity and financial burden is represented by infections involving these devices. They may affect only the gener...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-10-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/19/5898 |
| _version_ | 1797478521312903168 |
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| author | Filippo Toriello Massimo Saviano Andrea Faggiano Domitilla Gentile Giovanni Provenzale Alberto Vincenzo Pollina Elisa Gherbesi Lucia Barbieri Stefano Carugo |
| author_facet | Filippo Toriello Massimo Saviano Andrea Faggiano Domitilla Gentile Giovanni Provenzale Alberto Vincenzo Pollina Elisa Gherbesi Lucia Barbieri Stefano Carugo |
| author_sort | Filippo Toriello |
| collection | DOAJ |
| description | The use of increasingly complex cardiac implantable electronic devices (CIEDs) has increased exponentially in recent years. One of the most serious complications in terms of mortality, morbidity and financial burden is represented by infections involving these devices. They may affect only the generator pocket or be generalised with lead-related endocarditis. Modifiable and non-modifiable risk factors have been identified and they can be associated with patient or procedure characteristics or with the type of CIED. Pocket and systemic infections require a precise evaluation and a specialised treatment which in most cases involves the removal of all the components of the device and a personalised antimicrobial therapy. CIED retention is usually limited to cases where infection is unlikely or is limited to the skin incision site. Optimal re-implantation timing depends on the type of infection and on the results of microbiological tests. Preventive strategies, in the end, include antibiotic prophylaxis before CIED implantation, the possibility to use antibacterial envelopes and the prevention of hematomas. The aim of this review is to investigate the pathogenesis, stratification, diagnostic tools and management of CIED infections. |
| first_indexed | 2024-03-09T21:33:01Z |
| format | Article |
| id | doaj.art-085c900a13414a25b415c99cda249f64 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T21:33:01Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-085c900a13414a25b415c99cda249f642023-11-23T20:50:41ZengMDPI AGJournal of Clinical Medicine2077-03832022-10-011119589810.3390/jcm11195898Cardiac Implantable Electronic Devices Infection Assessment, Diagnosis and Management: A Review of the LiteratureFilippo Toriello0Massimo Saviano1Andrea Faggiano2Domitilla Gentile3Giovanni Provenzale4Alberto Vincenzo Pollina5Elisa Gherbesi6Lucia Barbieri7Stefano Carugo8Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, ItalyDepartment of Internal Medicine, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, 20122 Milan, ItalyDepartment of Clinical Sciences and Community Health, University of Milan, 20122 Milan, ItalyDepartment of Internal Medicine, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, 20122 Milan, ItalyDepartment of Internal Medicine, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, 20122 Milan, ItalyDepartment of Internal Medicine, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, 20122 Milan, ItalyDepartment of Internal Medicine, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, 20122 Milan, ItalyDepartment of Internal Medicine, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, 20122 Milan, ItalyDepartment of Clinical Sciences and Community Health, University of Milan, 20122 Milan, ItalyThe use of increasingly complex cardiac implantable electronic devices (CIEDs) has increased exponentially in recent years. One of the most serious complications in terms of mortality, morbidity and financial burden is represented by infections involving these devices. They may affect only the generator pocket or be generalised with lead-related endocarditis. Modifiable and non-modifiable risk factors have been identified and they can be associated with patient or procedure characteristics or with the type of CIED. Pocket and systemic infections require a precise evaluation and a specialised treatment which in most cases involves the removal of all the components of the device and a personalised antimicrobial therapy. CIED retention is usually limited to cases where infection is unlikely or is limited to the skin incision site. Optimal re-implantation timing depends on the type of infection and on the results of microbiological tests. Preventive strategies, in the end, include antibiotic prophylaxis before CIED implantation, the possibility to use antibacterial envelopes and the prevention of hematomas. The aim of this review is to investigate the pathogenesis, stratification, diagnostic tools and management of CIED infections.https://www.mdpi.com/2077-0383/11/19/5898cardiac implantable electronic device infectionpocket infectionantimicrobial therapyrisk factorspreventive strategies |
| spellingShingle | Filippo Toriello Massimo Saviano Andrea Faggiano Domitilla Gentile Giovanni Provenzale Alberto Vincenzo Pollina Elisa Gherbesi Lucia Barbieri Stefano Carugo Cardiac Implantable Electronic Devices Infection Assessment, Diagnosis and Management: A Review of the Literature Journal of Clinical Medicine cardiac implantable electronic device infection pocket infection antimicrobial therapy risk factors preventive strategies |
| title | Cardiac Implantable Electronic Devices Infection Assessment, Diagnosis and Management: A Review of the Literature |
| title_full | Cardiac Implantable Electronic Devices Infection Assessment, Diagnosis and Management: A Review of the Literature |
| title_fullStr | Cardiac Implantable Electronic Devices Infection Assessment, Diagnosis and Management: A Review of the Literature |
| title_full_unstemmed | Cardiac Implantable Electronic Devices Infection Assessment, Diagnosis and Management: A Review of the Literature |
| title_short | Cardiac Implantable Electronic Devices Infection Assessment, Diagnosis and Management: A Review of the Literature |
| title_sort | cardiac implantable electronic devices infection assessment diagnosis and management a review of the literature |
| topic | cardiac implantable electronic device infection pocket infection antimicrobial therapy risk factors preventive strategies |
| url | https://www.mdpi.com/2077-0383/11/19/5898 |
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