Assessment of Diagnostic and Therapeutic Practices for Cardiac Implantable Electronic Devices Suspected Infections in Nancy University Hospital

Study Overview
=================
Brief Summary
-----------------
The frequency of cardiac implantable electronic devices (CIED) is constantly increasing. Devices infections are one of the most serious complications in terms of morbidity and mortality. Although the frequency of cardiac implantable devices infections is difficult to derminate due to divergent definitions, cohort studies report a trend of increasing. The infection can be localized at the pocket of the implantation, at intravascular or intra-cardiac portion of leads. Infectious endocarditis defined by involvement of the intra-cardiac portion of leads is the most serious form. The diagnosis is based on clinical, biological and multimodal imagery data. Early diagnosis and specific management are necessary to reduce mortality and morbidity. Since the last European recommendations on infectious endocarditis in 2015, the HeartRythm Society of patient described an algorithm to treat CIED infections and extraction indications. However, in practice, management of CEID infections remains center-dependent and data from robust international studies are missing. The main objective of our study is to evaluate the management of CEID suspected infections and the prognosis at 1 year in terms of survival according to the methods of treatment at the Nancy University Hospital and to compare the treatment with the latest recommendations in force

Official Title
-----------------
Assessment of Diagnostic and Therapeutic Practices for Cardiac Implantable Electronic Devices Suspected Infections in Nancy University Hospital

Conditions
-----------------
Cardiac Implantable Electronic Device Infections

Intervention / Treatment
-----------------
* Other: Diagnostic and treatment evaluation


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: All patients who have been hospitalized in Nancy University Hospital between January 2014 et July 2019 for suspected infection of cardiac implantable electronic device Exclusion Criteria: Minor patients Epicardial CIED

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Cardiac implantable electronic device infections<br>Patients hospitalised in Nancy University Hospital for suspected cardiac implantable electronic device infections | Other: Diagnostic and treatment evaluation<br>* No intervention, description of the diagnostic evaluation and the treatment<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Description of the practice | Describe the diagnostic and therapeutic practices of patients hospitalized for CIED suspected infection | From January 2014 to July 2020 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Evaluation of local practices against current recommendations | Classify patients in 3 groups (1 = Cardiac implantable electronic device infection ; 2 Pocket infection without proof of lead involvements ; 3 = systemic infection related to infective valvular endocarditis or not without proof of lead involvements according to our local practices and criteria, to EHRA criteria and modified Duke Li criteria). Compare diagnostic management in our center with EHRA recommendations in each groups Compare therapeutic management including removal/extraction of cardiac implantable electronic device, antibiotic therapy Assessment of adhering to EHRA recommendations Pronostic evaluation according to removal/extraction or not based on survival curve | From January 2014 to July 2020 |