Journal Article Epublish 4 citations
PubMed: 42277675 DOI: 10.1186/s12872-026-06124-w
Trends in cardiac implantable electronic device infections: 2015 to 2019.
BMC Cardiovasc Disord 26(1)
Authors: Benito Baldauf, Kerstin Bode, Ernest W Lau, Marzia Giaccardi, Ojan Assadian, Philippe Chévalier, Christelle Haddad, Andreas Klöss, Roberto Cemin, Reinhard Vonthein, Hendrik Bonnemeier
Affiliations
- Institute of Life Sciences, Hochschule Bremerhaven, University of Applied Sciences, An der Karlstadt 8, Bremerhaven, 27568, Germany.
- Medical Faculty, Christian-Albrechts University, Christian- Albrechts-Platz 4, Kiel, 24118, Germany.
- Department of Electropyhsiology, Herzzentrum Leipzig, Strümpellstraße 39, Leipzig, 04289, Germany.
- Department of Cardiology, Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA, UK.
- Asklepios Hospital Schildautal, Karl-Herold-Str. 1, 38723, Seesen, Germany.
- Department of Cardiology, Ospedale Santa Maria Annunziata, Ponte a Niccheri, Florence, 50012, Italy.
- Meyer Children' Hospital IRCCS, Viale Gaetano Pieraccini, 24, Firenze, FI, 50139, Italia.
- University Hospital Wiener Neustadt, Corvinusring 3-5, Wiener Neustadt, 2700, Austria.
- Institute for Skin Integrity and Infection Prevention, School of Human and Health Sciences, University of Huddersfield, Huddersfield, HD1 3DH, UK.
- Department of Cardiology, Hôpital Louis Pradel, 59 Bd Pinel, Bron, 69500, France.
- Research Institute of the Local Health Care Funds, Berlin, Germany.
- Intensive care unit, Ospedale Regionale San Maurizio, Via Lorenz Böhler 5, Bolzano, 39100, Italy.
- Institut für Medizinische Biometrie und Statistik, Universität zu Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
- Medical Faculty, Christian-Albrechts University, Christian- Albrechts-Platz 4, Kiel, 24118, Germany.
Abstract
BACKGROUND
Cardiovascular implantable electronic devices (CIEDs) improve survival in patients with cardiac rhythm disorders but carry risks of complications, most notably major infections. Reported infection rates vary internationally, and contemporary large-scale data from Germany are scarce. We aimed to determine nationwide rates of CIED infection-related hospitalizations and associated mortality over a five-year period.
METHODS
We analyzed administrative claims from Germany's largest statutory health insurer covering more than 27 million beneficiaries. All CIED procedures performed between January 2015 and December 2019 were identified, including initial implantations, upgrades or downgrades, generator replacements, early revisions, and device extractions. Major infections were detected using International Classification of Diseases (ICD-10-GM) and procedural codes, and stratified as generator pocket infections or lead-associated endocarditis. In-hospital mortality was determined from discharge records.
RESULTS
Among 282,205 patients (57.7% male) undergoing CIED procedures, 6,577 individuals (2.33%) experienced 7,704 major infections within three months. Generator pocket infections occurred in 5,396 cases (1.91%), lead-associated endocarditis in 2,308 (0.82%), and combined infections in 1,127 patients (0.39%) within the acute 90-day observation period. CIED infections substantially increased healthcare utilization: Infected patients required substantially more procedures than non-infected patients, despite correct treatment. In-hospital mortality reached 8.36% for pocket infections and 15.0% for endocarditis. Extended follow-up in the 2015 cohort revealed a 4.33% infection-related procedure rate over five years.
CONCLUSIONS
Nationwide German data reveal higher acute CIED infection rates than previously reported, with considerable mortality and procedural burden. These findings highlight an urgent need for improved prevention and management strategies.
MeSH
Mortality, Cardiovascular Diseases, Hospital Mortality, Endocarditis, Infections