Sekiguchi Yukio
Cardiovascular Division, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
J Arrhythm. 2016 Aug;32(4):293-6. doi: 10.1016/j.joa.2015.09.012. Epub 2015 Nov 19.
Along with the increased frequency of implantation, the incidence of cardiac implantable electronic device (CIED) infection, which can have serious or fatal complications, has also increased. Although several successful conservative therapies for CIED infection have been reported, retained infected devices remain a source of relapse, which is closely related to a higher mortality rate. Presently, complete hardware removal is initially recommended for infected CIED patients, and indications for conservative therapy, including continuous administration of antibiotics, require careful consideration. On the other hand, complete removal is not required for superficial or incisional infection at the device pocket if an infection does not involve the device, but the patient should be closely followed for progression to deeper infection, which would require extraction.
随着植入频率的增加，可引发严重或致命并发症的心脏植入式电子设备（CIED）感染的发生率也有所上升。尽管已有数例CIED感染成功保守治疗的报道，但保留感染的设备仍是复发的根源，这与较高的死亡率密切相关。目前，对于感染CIED的患者，最初建议彻底移除硬件，而保守治疗（包括持续使用抗生素）的指征需要仔细考虑。另一方面，如果感染未累及设备，对于设备囊袋处的浅表或切口感染则无需彻底移除，但应密切观察患者是否进展为需要取出设备的深部感染。
