2019 EHRA International Consensus Document on How to Prevent, Diagnose, and Treat Cardiac Implantable Electronic Device Infections

November 8, 2019—The aim of this document is to describe the current knowledge on the risks for device-related infections and to assist health care professionals in clinical decision making regarding their prevention, diagnosis, and management by providing the latest update of the most effective strategies.

Pacemakers, implantable cardiac defibrillators, and cardiac resynchronization therapy devices are life-saving treatments for a number of cardiac conditions. Device-related infection is, however, one of the most serious complications of cardiac implantable electronic device (CIED) therapy associated with significant morbidity, mortality, and financial health care burden. Although many preventive strategies such as administration of intravenous antibiotic therapy before implantation are well recognized, uncertainties still exist about other regimens. Questions still remain such as the use of CIED alternatives expected to be less prone to infections and how to manage medication, such as anticoagulants during CIED surgery, and the role of minimum quality and volume requirements for centers and operators. The recognition of these gaps in knowledge, reports of new important randomized trials, observed divergences in managing device-related infections, and the lack of international consensus documents specifically focusing on CIED infections provided a strong incentive for this consensus document on risk assessment, prevention, diagnosis, and management of CIED infections.

The Heart Rhythm Society endorsed the document on July 28, 2019.