The number of electronic cardiac devices, including pacemakers and cardioverter-defibrillators, being implanted each year is increasing.\u00a0 As a result, there has been a 210% increase in the incidence of device infection between 1993 and 2008 in the United States.\u00a0 Cardiac device infective endocarditis (CDIE) is significant in that it is associated with a higher mortality rate than device infection without endocarditis.<\/p>\n
Athan et al. examined prospective data from the International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS), collected from 61 centers in 28 countries over a six year period.\u00a0 All patients were hospitalised adults with definite endocarditis as defined by the modified Duke endocarditis criteria.\u00a0 The authors examined in-hospital and 1-year mortality.<\/p>\n
CDIE was diagnosed in 6.4% of patients with definite infective endocarditis.\u00a0 CDIE generally occurred in older patients (median age, 71.2 years), was caused by staphylococci (66.6% of patients), and was associated with contact with health care services (45.8%).\u00a0 37.3% of patients also had co-existing valve involvement (especially the tricuspid valve).\u00a0 In-hospital and one-year mortality rates were 14.7% and 23.2%, respectively.\u00a0 Removal of the device was associated with an increased chance of survival at one year (hazard ratio 0.42 when compared to patients who did not undergo device removal).<\/p>\n
Conclusion:<\/strong><\/p>\n Patients with cardiac device infective endocarditis have high rates of mortality and concomitant valve infection.\u00a0 Early device removal is indicated to improve survival at one year.<\/p>\n