AHA calls for action to improve care following CIED infection

A new report from the American Heart Association’s (AHA’s) National Cardiac Implantable Electronic Device (CIED) Infection Initiative aims to improve adherence to guidelines on device explant following an infection.

The report is the result of a summit of key opinion leaders, stakeholders, medical societies, patient groups and other system of care participants convened by AHA, held in March, which aimed to identify barriers, opportunities and recommendations to support improved awareness, detection and management of CIED infections.

Although timely removal of the device is the most appropriate treatment option for patients who develop a CIED infection, many do not receive this procedure, according to a study in the AHA journal Circulation: Arrhythmia and Electrophysiology.

Researchers found that only around one in five patients with a CIED infection had their devices explanted.

“CIED infections, although not frequent, are not rare either, and recent research shows just one in five patients with a CIED infection has the device fully removed,” said Bruce Wilkoff (Cleveland Clinic, Cleveland, USA), volunteer chair of the American Heart Association CIED Infection Summit planning group. “The cost is pain, hospitalisation, surgery and, when not recognised and treated appropriately, death. Although effective therapies are available, many of these infections are not detected or treated according to guidelines.”

The resulting call to action is multifaceted and relies on healthcare professionals evaluating how CIED infection patients are being treated, driving guideline adherence, and communicating existing gaps in care, AHA said in a press release. Patients are called on to advocate for their own health. Stakeholders identified an initial road map to drive change that is outlined in action items organized according to three categories:

• Prevention, Detection and Diagnosis: Identifying the most critical problems across clinical settings, connecting the dots for clinicians, including the role of informatics.
• Improving Treatment and Management of CIED Infection: Recommendations to enhance systems of care.
• Awareness and Education: Examples of consumer and health care professional initiatives in other diseases.

The American Heart Association’s National CIED Infection Initiative, which began in 2021, is supported by Philips Image-Guided Therapy.