Work

Contemporary practice about cardiac implantable electronic device infections prevention a french multicenter survey

Year: 2025

Type: article

Abstract: Background: Cardiac implantable electronic device infections remain a major complication. Preventive measures include antiseptic skin preparation, systemic antibiotic prophylaxis, and more recently the use of the absorbable TYRX antibiotic-eluting envelope (AEE). Despite explicit international recommendations, real-world adherence to guidelines is insufficiently documented. Objective: This study aimed to assess infection prevention practices across French hospital centers, with a particular focus on the recent European Society of Cardiology recommendations regarding AEE use. Methods: Data were collected from 33 French centers (51.3% private, 21.2% academic, 27.3% general hospitals). Each practitioner reported data for 5 patients. A structured questionnaire, validated by 2 international experts, addressed key prevention strategies with specific emphasis on AEE. Results: carriage was infrequent (18.2%), whereas systematic C-reactive protein measurement was more common (63.6%). Intravenous antibiotic prophylaxis was reported in 93.9% of cases, administered within 1 hour before implantation in 77.4%. Skin preparation with 2% alcoholic chlorhexidine and pocket irrigation with physiological saline were both used in 39.4% of cases. AEE was not systematically applied in reimbursed indications (42.4%), with an overall adherence rate to recommendations of 59.5%. Conclusion: This multicenter French survey highlights substantial gaps in physicians' knowledge and application of cardiac implantable electronic device infection prevention practices, despite the availability of clear European Society of Cardiology guidelines.

Source: Heart Rhythm O2

DOI: 10.1016/j.hroo.2025.10.009

Authors: Antoine Da Costa, Marc Goralski, Aurélie Guiot, Isabelle Lecardonnel, Jean Claude Deharo