Pacemaker and ICD infections: From diagnosis to treatment
Benák Attila, Sághy László
SZTE ÁOK, II. sz. Belgyógyászati Klinika és Kardiológiai Központ, Szeged
The cardiac implantable electronic devices (CIED) infections are increased in the past decade, due to the rising number of ICDs and biventricular devices. The infections can occur in local and systemic forms. The pathogen agents are the Staphylococcus species in the majority of cases, which can be explained by the special virulence factors. The diagnosis is simple in the following conditions: generator decubitus, fistule, lead vegetation with positive hemocultures. When the diagnosis is uncertain, 18FDG-PET/CT can help in the decision. In case of CIED infection, extraction of the complete system is recommended. Transvenous lead extraction should be the first choice, except for high risk patient or massive lead vegetation. Preoperative antibiotic prophylaxis is the only proven method for prevention. The widespread usage of the absorbable antibacterial envelope can be the future of CIED infection control.