ABSTRACT
By the year 2000, there were approximately 200,000 implantable cardiac defibrillators and 3.5 million permanent pacemakers throughout the world (1). It is estimated that 400,000 intracardiac defibrillators (ICDs) are placed in the United States each year (2). This has increased by more than 600% in the 1990s. The insertion of left ventricularassist devices (LVAD) is also growing. Through the 1990s, implantation of intracardiac devices of all types increased by 42%. However, total device infections went up by 124%. The rate of device-related infective endocarditis (IE) remained fairly constant (0.5% of insertions) (3). This alarming increase in infections may be due to the disproportionate rise in placement of ICDs (4,4a) and their infectious complications. As with prosthetic valves, intracardiac devices are a double-edged sword. They prolong and improve the quality of life while always posing significant infectious risks to the patient.
