**3. Conclusions**

*Advanced Concepts in Endocarditis - 2021*

**136**

**2.10 Prognosis**

*Subcutaneous defibrillator.*

**Figure 12.**

**Figure 11.** *MICRA.*

pocket infection.

CIED infection is a serious pathology with a 30-day hospital mortality estimated between 4.6–11% (despite the heterogeneity of the studies) [37]. Studies that included only patients with CIED -IE reported high mortality: 24.5–29% with follow-up periods of up to a year and explant rates of 80–100% [6]. It is associated with systemic infection and sepsis, complications derived from extraction and reimplantation and the own comorbidities of the patients. Long-term mortality is between 1.5 and 2.4 times higher than in CIED carriers without infectious complications. Mortality is high during the first year following CIED infection, but many deaths are not infection related. Abnormal renal function is the most consistently identified risk factor for mortality. Failure to remove an infected device is associated with relapse and mortality. CIED-IE has a higher mortality than localized generator

For all these reasons, infections in patients with CIED and especially those with suspected or confirmed systemic involvement should be considered a medical emergency, that must receive a multidisciplinary approach by a team

Infective endocarditis is a prevalent pathology in developed countries. Its spectrum is changing and its association with intracardiac devices has increased disproportionately in recent decades. Affected patients are especially vulnerable to complications due to both their cardiac and extra-cardiac pathologies and their frequent contact with health-related procedures. Most of these infections are caused by S Aureus and CoNS, many times carriers of antibiotic resistance and must be treated early and aggressively by multidisciplinary teams. We must be careful in the indication and choice of devices and exquisite in the prevention of infections since once established, therapeutic failure entails high morbidity and mortality.
