Cardiovascular implantable electronic devices (CIEDs) are life sustaining for many patients; however, they may come at a lofty price, which includes risk of infection. While the devices may help to prolong the lives of many, they also carry some risk.
The American Heart Association recently noted that device implantation for pacemakers and implantable cardioverter-defibrillators (ICDs) increased 19 percent and 60 percent, respectively. This spike in implantation rates also ups the ante for infection. A National Hospital Discharge survey found that CIED infection rates rose almost three-fold for pacemakers and six-fold for ICDs, perhaps leaving patients wondering if the benefits are worth the apparent risks.
Shedding some clinical light on the topic, a study in this week's Journal of the American Medical Association touched upon how patients with cardiac device infective endocarditis have higher rates of concomitant valve infection and mortality.
Another study offered hope because researchers found that PET/CT may
help differentiate between CIED infection and post-implant changes. Researchers from Quebec City found that 18F-FDG PET/CT could help differentiate between active device infection and residual normal post-operative inflammation that is often present four to eight weeks post-operation.
Perhaps this study will offer a dose of good news, as in an accompanying editorial Jeffrey A. Brinker, MD, of Johns Hopkins University in Baltimore, noted that the PET/CT method could help detect infective endocarditis and potentially help cancel out harm.
Brinker even went as far as to question whether 18F-FDG PET may become part of routine CIED infection evaluations.
Despite the fact that infection rates may be small (three to four infections per 1,000 device implants), some of these infections may be preventable. In addition, the prevention of these types of infections could be just one factor that helps reduce the hefty price tag of healthcare costs.
What are you doing to stamp out infection? Enhanced hygiene? Sophisticated imaging? Email me and let me know your strategies.
Associate Editor, Cardiovascular Business