Risk of infective endocarditis associated with invasive dental procedures in patients with cardiac rhythm devices. Issue 12 (13th June 2022)

• Record Type: Journal Article
• Authors: Kim, Ju Youn; Park, Seung-Jung; Lee, Sang Hwa; Seo, Gi Hyeon; Jang, Sung-Won
• Is Part Of: Europace. Volume 24:Issue 12(2022)
• Page Start: 1967
• Page End: 1972
• Publication Date: 2022-06-13
• Subjects: Cardiac implantable electronic device -- Infective endocarditis -- Invasive dental procedure; Arrhythmia -- Treatment -- Periodicals; Cardiac pacing -- Periodicals; Catheter ablation -- Periodicals; Heart -- Physiology -- Periodicals; Electrophysiology -- Periodicals; 617.4120645
• DOI: 10.1093/europace/euac086
• Languages: English
• ISSNs: 1099-5129

Abstract

Abstract: Aims: The incidence of infective endocarditis related to cardiac implantable electronic devices (CIEDs) has gradually increased. The risk associated with dental procedures in patients with CIED implantation and the need for prevention of infective endocarditis remain unclear. The present study investigated the incidence and risk of infective endocarditis associated with invasive dental procedures in patients with CIEDs. Methods and results: We analysed a nationwide population-based cohort of patients with CIEDs who underwent dental procedures. We performed a self-controlled case series analysis and evaluated the incidence rate ratio of infective endocarditis 3 months after dental procedures. Of a total of 62 019 patients who underwent CIED implantation, 32 536 patients underwent at least one dental procedure during follow-up, and the mean number of dental procedures was 3.4 per patient. They were 152 infections with an incidence of 445 per 100 000 person-years in the dental procedure period and 500 events at an incidence of 255 per 100 000 person-years in the non-dental procedure period. The CIED-related infective endocarditis in the dental procedure period occurred significantly more frequently than during non-dental procedure periods (odds ratio, 1.75; 95% confidence interval, 1.48–2.05; P < 0.001). The mean time interval from dental procedure to infective endocarditis was 59.6 ± 47.3 days. Conclusion: Invasive dental procedures are associated with an increased risk of infective endocarditis in those who underwent CIED implantation. Appropriate preventive therapy might be needed in these patients.