Cardiac Implantable Electronic Device Infection Summit: Bridging gaps in awareness, detection, and appropriate treatment of CIED infections

The use of cardiac implantable electronic devices is becoming more and more common. Between 1993 and 2008, more than 4.2 million primary implantations of pacemakers and implantable cardioverter-defibrillators took place, according to an analysis of ICD-9-CM procedure codes.1 While these devices extend and improve people’s lives with minimal problems in most cases, for patients who experience infections related to their devices, gaps and delays in care can lead to preventable illness, disability and death. The American Heart Association (AHA) launched an initiative to improve awareness, detection, diagnosis and treatment of CIED infection through a two-year effort including a National CIED Infection Summit and a National Health Care Professional Education Plan. At the same time, patient advocacy groups Arrhythmia Alliance and Mended Hearts launched a patient-facing educational initiative, also supported by Philips Image Guided Therapy, to identify the issues patients face in detection and treatment of CIED infection. Cardiac Implantable Electronic Device (CIED) Infection Summit | 4 In March 2022, the AHA led by a nine-member planning committee convened multidisciplinary stakeholders at the in-person CIED Infection Summit and identified three major problems to solve and three preliminary actionable solutions:PROBLEMS TO SOLVE CIED infections are rising, despite advances in our understanding of their clinical elements.2 CIED infections result in substantial morbidity and mortality that can be reduced if optimally treated.3,4 Patient and procedural factors and physician experience combine to optimize care of CIED infections, but coordinated systematic approaches are lacking. Patients and physicians play a role in CIED infection care, and communication between these stakeholders is critical. Health care burdens related to CIED infection are substantial,5 thus health systems could provide higher-value care by addressing this problem.ACTIONABLE SOLUTIONS Convene interdisciplinary medical professionals to learn about optimal CIED infection care. Create and disseminate tailored education to multidisciplinary teams of health care professionals, administrators and patients. Focus on optimal care where all eligible patients are engaged, well-informed, and referred for treatment. The CIED Infection Initiative has two phases: Phase 1: Convene key opinion leaders, stakeholders, medical societies, patient groups and other system-of-care participants for a national summit aimed at identifying barriers, opportunities and recommendations to improve awareness and detection of CIED infections. Phase 2: Build understanding of the gap in guideline-recommended care to improve CIED patient care by creating educational resources for professionals, with a series of resources released through June 2023. Insights and best practices identified at the summit inform educational activities to be promoted and disseminated across the AHA’s extensive network. In addition, the AHA has well-established relationships with key collaborators who can play a vital role in future phases of the CIED Infection Initiative.