Margey Ronan
Divisionof Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02109, USA.
J Long Term Eff Med Implants. 2010;20(3):203-17. doi: 10.1615/jlongtermeffmedimplants.v20.i3.40.
The use of cardiac implantable electronic devices has increased exponentially in recent years with expanding indications and the aging of the general population. Despite improvements in device design, infection control practices, and the administration of antibiotic prophylaxis, the rate of cardiac implantable electronic device (CIED) infection has increased at a faster rate. With CIED infection becoming an increasing management problem, the purpose of this paper is to review the epidemiology, causes, pathogenesis, management and outcomes of CIED infection, and to summarize the recent updated guidelines published by the American Heart Association. While an extensive retrospective literature exists, only a few prospective clinical studies exist to help guide our management of this important problem. Research continues into the diagnosis, treatment and prevention of CIED infection. CIED infection is a growing clinical problem with significant morbidity and mortality. Summarizing the currently available literature, CIED infection is best managed by a combined strategy of complete device and lead extraction plus appropriately tailored antimicrobial therapy.
近年来，随着适应证的扩大和普通人群的老龄化，心脏植入式电子设备的使用呈指数级增长。尽管设备设计、感染控制措施以及抗生素预防的应用有所改进，但心脏植入式电子设备（CIED）感染率却以更快的速度上升。随着CIED感染成为一个日益严重的管理问题，本文旨在综述CIED感染的流行病学、病因、发病机制、管理及结局，并总结美国心脏协会发布的最新指南。虽然存在大量回顾性文献，但仅有少数前瞻性临床研究可帮助指导我们对这一重要问题的管理。关于CIED感染的诊断、治疗及预防的研究仍在继续。CIED感染是一个日益严重的临床问题，具有显著的发病率和死亡率。总结目前可得的文献，CIED感染的最佳管理策略是完整取出设备和导线，并结合适当定制的抗菌治疗。
