Management and Outcome of Permanent Pacemaker and Implantable Cardioverter-Defibrillator Infections

Management and Outcome of Permanent Pacemaker and Implantable Cardioverter-Defibrillator Infections Muhammad R. Sohail, Daniel Z. Uslan, Akbar H. Khan, Paul A. Friedman, David L. Hayes, Walter R. Wilson, James M. Steckelberg, Sarah Stoner, Larry M. Baddour We retrospectively analyzed 189 cases of permanent pacemaker and implantable cardioverter-defibrillator infection that were seen at Mayo Clinic Rochester between 1991 and 2003. The majority (96%) of patients were cured with complete removal of the infected device and antibiotic treatment. Duration of antibiotic therapy was dependent on the clinical syndrome of infection (median duration of 18 days for pocket infection vs. 28 days for endocarditis) and the defined pathogen (28 days for Staphylococcus aureus infection vs. 14 days for coagulase-negative staphylococcal infection, p < 0.001). Based on the findings of our analysis and review of the published literature, we propose Mayo Clinic guidelines for the management of cardiac device infection.