An infection of a pacemaker or implantable cardioverter defibrillator (ICD) can be serious for the patient. Recognition of risk factors can help identify patients who may benefit from closer monitoring and more aggressive management.
Surgical risk factors:
(1) re-operation (battery replacement, lead repair, etc.)
(2) inexperienced operator (< 100 procedures)
(3) longer operative time
(4) hematoma
(5) failure to carefully clean skin at the operative site
Type of device:
(1) temporary transvenous pacemaking
(2) epicardial ICD
Patient comorbid conditions:
(1) diabetes mellitus
(2) immunosuppression
where:
• The number of leads (single vs dual chamber devices) is not an independent risk factor.
• The risk associated with a hematoma may explain why patients on anticoagulants may have a higher infection rate.
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