Infections involving implanted cardioverter defibrillator devices.

Infection is one of the most serious complications in patients with an implanted cardioverter defibrillator. The diagnosis is facilitated by computed tomographic and radionuclide imaging. Infection may be caused by intraoperative contamination or hematogenous seeding. In view of the serious consequences, the emphasis should be on prevention of these events. Perioperative antibiotic prophylaxis is common practice but the utility of prophylactic antibiotic remote from surgery is questionable. Strict adherence to asepsis and a meticulous surgical technique are essential. Identification of risk factors in the individual patient allows a patient-tailored treatment policy that may add to infection prevention. If implant infection does occur, complete removal of the system is most successful.