title: Cardiac Implantable Electronic Device Infection in Patients at Risk.
abstract: The incidence of infection following implantation of cardiac implantable electronic devices (CIEDs) is increasing at a faster rate than that of device implantation. Patients with a CIED infection usually require hospitalisation and complete device and lead removal. A significant proportion die from their infection. Transvenous lead extraction (TLE) is associated with rare but serious complications including major vascular injury or cardiac perforation. Operator experience and advances in lead extraction methods, including laser technology and rotational sheaths, have resulted in procedures having a low risk of complication and mortality. Strategies for preventing CIED infections include intravenous antibiotics and aseptic surgical techniques. An additional method to reduce CIED infection may be the use of antibacterial TYRX™ envelope. Data from non-randomised cohort studies have indicated that antibacterial envelope use can reduce the incidence of CIED infection by more than 80 % in high-risk patients and a randomised clinical trial is ongoing.
authors.affiliation: Heart and Vascular Institute, Cleveland Clinic, Ohio, US.
authors.forename: Khaldoun G
authors.initials: KG
authors.lastname: Tarakji
authors.affiliation: Vanderbilt Heart and Vascular Institute at Vanderbilt University, Nashville, Tennessee, US.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Ellis
authors.affiliation: Centre Hospitalier Universitaire de Grenoble, La Tronche, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Defaye
authors.affiliation: Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Charles
authors.initials: C
authors.lastname: Kennergren
keywords: Cardiovascular implantable electronic device infections; antibacterial envelope; implantable cardioverter-defibrillators; pacemaker; transvenous lead extraction