Infected Heart Implants Often Left In Place, Despite Risks: Study

Patients often choose antibiotics to treat infected heart implants, when removing them entirely actually increases their chance of survival, researchers warn.

The majority of patients with infected heart implants do not get the devices removed, even if their doctors recommend it to lower the risk of serious injury or death, according to the findings of a new study.

Heart devices can become infected after being surgically implanted. However, according to researchers from the Duke Clinical Research Institute in Durham, North Carolina, more than 80% of patients who suffer an infection opt for antibiotic treatment, even though it is usually not the recommended course of treatment.

Doctors typically recommend patients with infected cardiac devices, such as defibrillators and pacemakers, undergo surgery to remove the devices, but many patients ignore the advice.

In a recent study, researchers analyzed Medicare data for nearly 1.1 million patients who received cardiac implantable electronic devices between 2006 and 2019. Approximately 1% of patients developed infections a year or more after implantation. Of those, 13% had the devices removed within six days and another 5% had them removed between day seven and day 30. However, 82% of patients decided to treat the infection only with antibiotics, despite the increased risk of death.

Having the cardiac devices removed results in a 43% lower risk of death, and the benefits of antibiotics are less certain, as previous research has indicated antibiotics do not clear infections involving electronic heart implants.

Cardiac device infections can be life threatening if left untreated or treated inadequately. The infection can spread to other parts of the body or through the bloodstream and lead to sepsis. It is important to treat the infection, but most doctors recommend having the cardiac device removed over treating the problem solely with antibiotics.

The death rate for patients who do not have the devices removed within a year of being diagnosed with a device infection was 32%, according to the findings. Comparatively, patients who have the devices removed within six days have an 18.5% risk of death, and patients who have the devices removed between days seven and 30 have a 23% risk of death.

Researchers say the findings of the study highlight an important gap in care and the need for cardiac implants to be removed when they become infected to help save the lives of the patients.

Because of the findings, the Duke Clinical Research Institute is launching a project within three U.S. health care systems to address the gap in care for cardiac device infections among patients and focusing on improved care and outcomes.

The findings were presented at the American College of Cardiology meeting in Washington D.C. Research presented at meetings and conferences is considered preliminary until published in a peer-reviewed journal.