Device infection

(Heart Rhythm 2017;14:e503, NEJM 2019;380:1895)

• Presents as pocket infection (warmth, erythema, tenderness) and/or sepsis w/ bacteremia
• ~2% over 5 y; if S. aureus bacteremia, infxn in ≥35%; antibacterial envelope ↓ risk
• TTE/TEE used to help visualize complic. (eg, vegetation), but even ⊖ TEE does not r/o
• Rx: abx; system removal if pocket infxn or GPC bacteremia; Ø routine abx prior to inv. proc.