Kirkfeldt Rikke Esberg, Johansen Jens Brock, Nielsen Jens Cosedis
Department of Cardiology, Aarhus University Hospital, Skejby, Denmark.
Department of Cardiology, Odense University Hospital, Odense, Denmark.
Arrhythm Electrophysiol Rev. 2016;5(3):183-187. doi: 10.15420/aer.2016:21:2.
Cardiac implantable electronic device (CIED) infection is an increasing problem. Reasons for this are uncertain, but likely relate to an increasing proportion of implantable cardioverter defibrillator (ICD) and cardiac resynchronisation therapy (CRT) devices implanted, as well as implantations in 'higher risk' candidates, i.e. patients with heart failure, diabetes and renal failure. Challenges within the field of CIED infections are multiple with prevention being the most important challenge. Careful prescription of CIED treatment and careful patient preparation before implantation is important. Diagnosis is often difficult and delayed by subtle signs of infection. Treatment of CIED infection includes complete system removal in centres experienced in CIED extraction and prolonged antibiotic therapy. Meticulous planning and preparation before system extraction and later CIED re-implantation is essential for better patient outcome. Future strategies for reducing CIED infection should be tested in sufficiently powered, multicentre, randomised controlled trials.
心脏植入式电子设备（CIED）感染是一个日益严重的问题。其原因尚不确定，但可能与植入式心脏复律除颤器（ICD）和心脏再同步治疗（CRT）设备植入比例的增加有关，也与在“高风险”候选者（即心力衰竭、糖尿病和肾衰竭患者）中进行植入有关。CIED感染领域面临的挑战众多，其中预防是最重要的挑战。谨慎开具CIED治疗处方以及在植入前仔细做好患者准备非常重要。感染的诊断通常很困难，且会因感染的细微迹象而延迟。CIED感染的治疗包括在有CIED取出经验的中心完全移除系统，并进行长期抗生素治疗。在系统取出及随后的CIED重新植入之前进行精心规划和准备，对于改善患者预后至关重要。未来减少CIED感染的策略应在足够有说服力的多中心随机对照试验中进行测试。
