Table 6. Cardiac device-related IE.

Guidelines	Recommendation	Level/class of evidence
ESC guidelines	Prolonged (i.e., before and after extraction) antibiotic therapy and complete hardware (device and leads) removal are recommended in definite CDRIE, as well as in presumably isolated pocket infection	I/C
	Complete hardware removal should be considered on the basis of occult infection without another apparent source of infection	IIa/C
	In patients with NVE or PVE and an intracardiac device with no evidence of associated device infection, complete hardware extraction may be considered	IIb/C
AHA/ACC guidelines	Complete removal of pacemaker or defibrillator systems, including all leads and the generator, is indicated as part of the early management plan in patients with IE with documented infection of the device or lead	I/B
	Complete removal of pacemaker or defibrillator systems, including all leads and the generator, is reasonable in patients with valvular IE caused by S. aureus or fungi, even without evidence of device or lead infection	IIa/B
	Complete removal of pacemaker or defibrillator systems, including all leads and the generator, is reasonable in patients undergoing valve surgery for valvular IE	IIa/C

Both guidelines recommend the removal and replacement of intra and extra cardiac devices, even if not located in the primitive site of the infection. The AHA/ACC guidelines pay more attention to the microorganism responsible for the infection. IE, Infective endocarditis; ESC, European Society of Cardiology; AHA, American Heart Association; ACC, American College of Cardiology; CDRIE, cardiac device related infective endocarditis; NVE, native valve endocarditis; PVE, prosthetic valve endocarditis.