Infections of implantable heart devices (for example, pacemakers) are becoming a growing problem, resulting in a high level of morbidity, mortality and medical expenses.

The objective of the study, conducted at the infectious disease unit of one of Australia's largest hospitals, Barwon Health (Geelong), was to study the clinical features and outcomes of infective endocarditis involving heart devices.

To achieve this objective, a prospective cohort study was conducted using data from the International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS), carried out between June 2000 and August 2006 at 61 Center in 28 countries. Study participants were adult hospital patients diagnosed with "endocarditis" according to the modified criteria for Duke endocarditis. The main results evaluated during the study were nosocomial mortality and mortality at 1 year.

Endocarditis involving implantable cardiac devices was diagnosed in 177 patients (6.4%) in a total cohort of 2,760 patients with an established diagnosis of infectious endocarditis. The clinical profile of endocarditis involving implantable cardiac devices included elderly patients (mean patient age 71.2 years), the cause was Staphylococcus aureus (62 cases, 35% and 1/3 of all staphylococci were resistant to methicillin) and coagulase negative staphylococci (56 cases, 31.6%); almost half of the cases of the disease were considered infections associated with the provision of medical care (81 cases, 45.8%). Concomitant heart valve damage was observed in 66 patients (37.3%), mainly a tricuspid valve in 43 patients (24.3%), which was associated with a high mortality rate. Nosocomial mortality was 14.7% (26/177 patients), mortality during the year was 23.2% (41/177). It turned out that the withdrawal of the device during initial hospitalization (28/141 patients (19.9%) with the remote device died at the end of 1 year had a favorable effect on survival at 1 year by compared to 13/34 patients (38.2%), by which the device was not removed).

Thus, in patients suffering from endocarditis with involvement of implantable cardiac devices, there is a high frequency of concomitant involvement of the valvular apparatus of the heart, a high mortality rate, in particular in the event of valvular involvement, and the Early removal of the implanted heart device increases the survival rate by one year.