Lead extraction is life-saving, yet patients are undertreated
New 2022 data performed by the American College of Cardiology (ACC) and presented at the American Heart Association (AHA) confirms discrepancies in physician knowledge and treatment of CIED infections. Among other significant gaps, the data indicates only 50% of cardiologists recommend guideline-driven care for CIED infections.1
What is a CIED infection?
The risk of CIED infection is rising, and the longer a device is implanted, the higher risk patients are for developing a device infection.2 If patients are not treated appropriately with prompt lead extraction, there is significant mortality and associated costs.3 Left untreated, device infections can lead to endocarditis and death.4
Cardiac implantable electronic device (CIED) infection occurs when an infection – either in the pocket or blood stream – has attached to the device or leads. Once an infection is in the blood stream, leads act as a highway to the heart and can spread the infection.
Pocket infection
A pocket infection begins in the pocket (where the generator is implanted) and attaches to the leads. A pocket infection can occur at the time of implantation or any time thereafter. The risk of infection increase every time the pocket is manipulated.5 Symptoms of pocket infections may include:6
Systemic infection
Systemic infection may develop elsewhere in the body – such as from a cut or wound that becomes infected and enters the bloodstream, eventually working its way to infect the leads and subsequently, the heart. Symptoms of systemic infections may be more elusive and general in nature, such as:6
Identifying the source of the infection
Identifying the source of a CIED infection can be difficult. However, with the incidence of infection on the rise,5 it is important to investigate the device if an infection is present. CIED infection can be fatal if not treated appropriately.7
320% Increase in CIED infection rates over a 10-year period5
> 31,000 US device patients diagnosed with an infection each year2,8
> 8 in 10 Patients not treated appropriately9 (from a 100% Medicare sample)
97.7% Clinical success rate10,11
99.72% Procedural safety rate10,11
Consequences of improper treatment
Infection relapse occurs in 50% to 100% of cases with partial removal or antibiotic treatment alone, compared to 0% to 4.2% relapse with complete system removal.7,14-17
In many cases, infections are caused by antibiotic-resistant staphylococcal bacteria that live in colonies called biofilm. The biofilm forms a thick coating around the device or leads that is nearly impossible to cure with antibiotic treatment alone.13
7 x increase in mortality 7-fold increase in 30-day mortality for antibiotic treatment without device removal7
42.9% lower risk of death
When leads are extracted within 6 days of CIED infection diagnosis9
Implementing a CIED infection care pathway
Philips is helping facilities around the world implement CIED infection care pathways, successful extraction programs, and EMR alert programs. Read this case study to learn more about how we can partner with you. Discover why a CIED care pathway is important and how to create your own team.
Implementing a CIED infection care pathway
Philips is helping facilities around the world implement CIED infection care pathways, successful extraction programs, and EMR alert programs. Read this case study to learn more about how we can partner with you. Discover why a CIED care pathway is important and how to create your own team.
Additional resources
Study
Low rates of guideline-directed care associated with higher mortality in patients with infected CIEDs
Recent 2022 ACC late-breaking data found that 8 in 10 patients with CIED infections are not treated according to Class I guidelines. Yet, lead extraction within 6 days of diagnosis is associated with a 42.9% lower risk of death.9
Study
Salvage failure of CIED infection
Read results from a multicenter study attempting to find clinical factors for device salvage with CIED infection.
Featured product
Philips Laser Sheath – GlideLight
Discover how laser lead extraction works.
Featured product
Philips Occlusion Balloon – Bridge
Learn how SVC tear survival has increased from 50% to 88.2% with Bridge.18
The American Heart Association’s National CIED Infection Initiative, supported by Philips Image Guided Therapy
Explore the association’s CIED Infection Report, watch webinars, listen to podcasts, and find other information on addressing the gaps in awareness, detection, and appropriate treatment of CIED infection.
This website is for healthcare providers to learn about the signs and symptoms of device infection, know the Class I indications around system removal and offer resources to further educate the community on how to identify and refer patients for potentially life-saving lead extraction. Members in your medical community that may need to be involved in diagnosis and treatment of CIED infections include:
(September2019).
