title: Infections of implantable cardiac rhythm devices: predisposing factors and outcome.
abstract: OBJECTIVE
  Infection is a serious complication of cardiac devices. We aimed to describe predisposing factors and outcome of permanent pacemaker (PPM) and implantable cardioverter/defibrillator (ICD) infections.
  
  
  METHODS
  We reviewed cardiac device infections diagnosed at the Yuksek Ihtisas Hospital Ankara, Turkey, between 2004 and 2010 retrospectively. Demographic and clinical data were collected, descriptive analysis was performed.
  
  
  RESULTS
  From 2004 to 2010, a total of 1916 devices were implanted. Thirty-four cases of confirmed device infections were identified giving an infection rate of 1.7%. Seventy-three percent of the cases were men. Mean age was 58 +/- 19 years. Twenty-two patients had a PPM, 12 had an ICD or cardiac resynchronization therapy (CRT). Diabetes mellitus, hypertension, cardiac failure, anaemia and immune suppression were prominent comorbidities. Previously, 6 (17%) patients had a history of replacement, 6 (17%) had revision, 3 (8%) had haematoma. Ten (29%) patients reported a history of long hospital stay and 13 (38%) patients had multiple hospitalizations. Pocket infection (70%) was the most common clinical presentation. Ninety-one percent of patients were cured with both device removal and antibiotic administration. Complications of cardiac device infections included septic emboli, acute renal failure, inotropic infusion requirement which were mostly seen among patients with endocarditis. Five patients suffered relapsing infection.Three patients died, among them two had infective endocarditis.
  
  
  CONCLUSIONS
  Cardiac device infections have been encountered more often in recent years. Cure of device infections is achievable in a majority of patients treated with antimicrobial treatment and complete device removal although device-related endocarditis can have an aggressive course.
authors.affiliation: Yuksek Ihtisas Hospital, Cardiology Clinic, Ankara, Turkey. esragucuk@hotmail.com
authors.forename: Esra Gucuk
authors.initials: EG
authors.lastname: Ipek
authors.forename: Umit
authors.initials: U
authors.lastname: Guray
authors.forename: Burcu
authors.initials: B
authors.lastname: Demirkan
authors.forename: Yesim
authors.initials: Y
authors.lastname: Guray
authors.forename: Tolga
authors.initials: T
authors.lastname: Aksu
mesh_terms: D016009:Chi-Square Distribution; D015897:Comorbidity; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D020878:Device Removal; D004452:Echocardiography; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D016459:Prosthesis-Related Infections / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology