Table 1.

CIED infection associated costs

Authors (year)	Study design	Country	Study period	Population	Infection associated costs
Ahsan et al. (2014)16	A retrospective audit of all cardiac device infections in a single tertiary referral institution	UK	2004–2007	2779 CIEDs implants or CIED-related procedures: 30 infections requiring CIEDs removal	Average cost: £30 958.40 per incident infection	Cost of cardiac device infection:	PM: £21 908.96 ICD: £294 162.88 CRT-D: £126 481.38
Brough et al. (2018)17	Retrospective, patient level service line analysis of a single UK extraction centre, during a complete financial year	UK	2013–2014	74 patients required transvenous extraction (47 infected and 27 non-infected; 156 leads) PM: 46% ICD: 23% CRT : 31%	Mean cost of extraction: £9228 (±4099):	Infected CIEDs £10 727 (±4178) Non-infected CIEDs £6619 (±2269)	When considering additional costs of device reimplantation:	Overall mean cost: £17 574 (±12 882) Infected CIEDs £22 615 (±13 343) Non-infected £8801 (±5007)
Clémenty et al. (2018)18	Retrospective analysis using medico-administrative hospital discharge database	France	2012–2015	78 267 CIED patients (72% de novo implants)	65 553 (84%) PM implantation	SCP: 18% DCP: 65% CRT-P: 4% P-undefined devices: 4%	11 845 (15%) Defibrillators	SCD: 27% DCD: 20% CRT-D: 34% D-undefined devices: 19%	2 years infection de novo mean cost per patient	Total CIED: €23 234 ± 50 294 SCP+DCP: €17 849 ± 14 025 CRT-P: €25 467 ± 22 894 SCD+DCD: €25 444 ± 23 560 CRT-D: €23 966 ± 23 379	2 years infection replacement mean cost per patient	Total CIED: €20 623 ± 18 778 SCP+DCP: €19 919 ± 18 029 CRT-P: €16 584 ± 10 461 SCD+DCD: €19 323 ± 8611 CRT-D: €27 449 ± 40 485
Egea et al. (2018)19	Cost analysis based on Delphi panel results on health resource utilization associated with the management of chronic pacemaker complications at the hospital level	Spain	2017	NR	Mean cost per infection requiring extraction and considering a 100% reimplantation rate:	PM: €21 196.44 ICD: €35 496.48 CRTs: €41 496.44	Cost for inpatient length of stay:	PM: € 13 917.53	Mean cost of intravenous antibiotic treatment previous and after system: €833.23/patient
Ludwig et al. (2018)20	Case-controlled analysis using PSM in patients with ICD/CRT-D using German health insurance claims data	Germany	2010–2014	158/4699 (3.4%) infections Risk of cardiac device infections 12 months post-implant: 3.4% overall, 2.9% for de novo procedures vs. 4.4% for replacement procedures	Mean 3-year incremental expenditure per patient for patients with cardiac devices infections:	€31 493 for de novo implant patients €33 777 for replacement patients.	Mean incremental expenditure: €59 419 per patient with a major infection
Ahmed et al. (2019)21	Retrospective analysis of clinical case records of pts undergoing extraction for CIED infection at a single tertiary cardiothoracic centre	UK	2013–2015	84 CIED patients CRT-D: 21.4% ICD : 28.6% PM : 50.0%	Median cost of a CIED extraction procedure £1729.95 (£942.41–£3588.90) Median cost of inpatient stay: £3150 (£700.00–£7700.00) Median cost outpatient antibiotic therapy:£3.47 (1.96–20.66) Cost of CIED infection episode according to device type: £5139 (PM) and £24 318 (CRT-D)
Burnhope et al. (2019)22	Retrospective cohort of HFrEF patients undergoing ICD or CRT procedures	UK	2014–2017	5/157 patients with CIED infection	Average cost of a CIED infection inpatient admission: £41 820 (range £28 377–£56 498)

CIED, cardiac implantable electronic device; CRT-D, cardiac resynchronization therapy-defibrillator; CRT-P, cardiac resynchronization therapy-pacemaker; DCP, dual-chamber pacemaker; ICD, implantable cardioverter-defibrillator; HFrEF, heart failure with reduced ejection fraction; PM, pacemaker; PMS, propensity score matching; SCP, single-chamber pacemaker.