Pathogenesis, diagnosis and treatment of infection of implantable cardiac pacemaker and automatic defibrillator

Cardiovascular implantable electronic device (CIED) infection has been increasing and the increasing rate of CIED infection is likely multifactorial in cause, involving both host and devicerelated factors including infection of the CIED itself, catheters, capsular bags, endocardium, arteriovenous soft tissues and bloodstream. The pathogenesis of infection is also related to many factors and diagnosis should be based on comprehensive local and systemic symptoms and signs, esophagus or transthoracic ultrasound examinations and bacterial cultures of tissues, secretions, catheters and blood. The key strategies of treatment include removing the infected CIED device if needed, antiinfective therapy, implanting new CIED devices and implantation timing. This study offers a threelevel prevention strategy for CIED infection.