Methods: Following an internally pilot study, an electronic survey was sent to all members of the Heart Rhythm Society, spanning 70 countries. All responses were collected anonymously.
Results: There were a total of 246 responders. The majority of surveys were completed by members from the US (168; 68.3%) and who practiced in academic medical centers (53.8%). While almost all locations (92.7%) had protocols in place to ensure appropriate timing of antimicrobial prophylaxis at the time of implant. The majority (76.1%) do not screen all patients for methicillin-resistant Staphylococcus aureus nasal colonization prior to implantation. Superficial (incisional) site infections were treated with antibiotics in accordance with guidelines only 52.5% of the time. Deep (pocket) infections were treated with antibiotics in accordance with guidelines only 37.4% of the time. Almost all providers (98.7%) noted that complete hardware extraction would be performed with identification of lead vegetation. In contrast, complete CIED removal would be performed in patients with an occult Gram-positive bacteremia (82.2%) and occult Gram-negative bacteremia (65.5%).
Conclusion: Despite overall consistency amongst national guidelines, wide variability exists in clinical practice globally. These findings suggest equipoise and the need for randomized clinical trials to clarify the optimal management strategies of CIED infections.
D. C. Desimone,
C. Desimone, None
S. Asirvatham, Medtronic: Consultant , Speaker honorarium
P. Friedman, None
L. M. Baddour, None
M. R. Sohail, None