Abstract

Background/Objectives: Cardiac implantable electronic device (CIED) infections are infrequent but clinically significant, and Latin American—particularly Chilean—data remain scarce. We aimed to describe the clinical and microbiological profile, complications, mortality, and local infection burden of CIED infections at a tertiary center in southern Chile. Methods: This was a retrospective descriptive cohort study of all patients treated for CIED infection at Hospital Dr. Hernán Henríquez Aravena between January 2015 and December 2021. Crude per-procedure infection proportions were calculated using locally implanted devices (primary implants, generator replacements, and upgrades) as the denominator; because annual implant volumes and individual follow-up times were not retrievable, only exploratory approximate rates per 100 patient-years were derived under strong assumptions and were not used for formal comparison. Results: Fifty-four patients were included (77.8% men; mean age 69 ± 14 years). Predominant comorbidities were arterial hypertension (79.6%), heart failure (40.7%), atrial fibrillation (27.8%), and type 2 diabetes mellitus (24.1%). Pacemakers accounted for 59.3% of infections, and late-onset cases predominated (48.2%). The overall per-procedure infection proportion was 1.4% (95% confidence interval [CI] 1.1–1.9%) and was numerically higher for implantable cardioverter-defibrillators (ICDs; 5.5%) and cardiac resynchronization therapy (CRT) devices (4.3%) than for pacemakers (1.1%). Coagulase-negative Staphylococcus (43.2%) and Staphylococcus aureus (24.3%) were the leading isolates, although microbiological sampling was incomplete (available in 68.5%). Complete system extraction was attempted in all patients and achieved in all but one case; recurrence occurred in 9.3% and in-hospital mortality in 1.9%. Conclusions: The clinical and microbiological profile of CIED infections in this single-center southern Chilean cohort was broadly consistent with international series. Per-procedure proportions for ICDs and CRT devices were numerically higher than those for pacemakers, but the retrospective design, a procedure-based denominator including replacements and upgrades, and incomplete echocardiographic and microbiological workup preclude formal comparison with time-to-event registries; these device-specific findings should be regarded as exploratory and hypothesis-generating. The findings identify concrete, locally actionable targets: more systematic microbiological sampling, broader pre-procedural and diagnostic echocardiography (including transesophageal studies), and strengthened long-term follow-up of CIED carriers.

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