Editorial Infections of Cardiac Implantable Electronic Devices

The use of cardiac implantable electronic devices (CIEDs), which includes permanent pacemakers and implantable cardioverter-defibrillators, has greatly increased over the past two decades. Unfortunately, along with the rising use of cardiac medical devices, there has been a disproportional increase in the number of infections of such devices [1]. The rates of infection of CIED range from 0.1 % to 4%, with an average rate of 1 % [2-4]. A recent analysis showed that infection rate grew from 1.61 % in 1993 to 2.41 % in 2008, possibly due to two factors: aging of population and increased use of more complex devices [5]. The most important risk factors for infection are re-intervention for hematoma evacuation or lead displacement, device replacement increasing with aging of population, and use of dual and triple chamber devices that increased in the last years. Staphylococcus epidermidis and Staphylococcus aureus, account for 70-90 % of all CIED infections, and have been studied extensively [6,7]. Non-staphylococcal organisms, which cause 10- 30 % of all CIED infections, are so diverse that they have been studied only infrequently [8]. The microbiological diversity of non-staphylococcal infections of CIED is rather extensive, including other Gram-positive bacteria, Gram-negative bacteria, atypica