REview and improvement of cardiac implanTable device Infection management qualitY initiative (RECTIFY): Rationale and design for a cardiac implantable electronic device infection quality initiative demonstration project.

BACKGROUND: Cardiac implantable electronic device (CIED) infections are a growing concern due to their associated high morbidity, mortality, and healthcare costs. Current guidelines given complete device and lead removal for CIED infection a class I recommendation, yet adherence to these guidelines is low with delays in extraction associated with poor adverse clinical events. OBEJCTIVES: To determine the effect of implementation of quality improvement (QI) interventions on patients with CIED infections, including rates of extraction and time to extraction. METHODS: This is a prospective interventional study conducted across 3 U.S. health systems that employs QI interventions aimed at increasing early identification of CIED infections. The study will have a retrospective review of treatment of CIED infection patients, followed by a 6-month QI intervention period, and a 12-month prospective data collection period after the QI intervention. Eligible patients will have a CIED and a presumed CIED infection (pocket or systemic infection). The primary endpoints are the change in the number of extractions performed for CIED infections and the time to extraction during the study. CONCLUSIONS: The REview and improvement of Cardiac implanTable device InFection qualitY initiative (RECTIFY) is a multi-center demonstration project aimed to identify and address health system-wide barriers to timely diagnosis and guideline-driven management of CIED infections. TRIAL REGISTRATION: The trial was registered with the U.S. National Library of Medicine at the National Institutes of Health (NCT05471973).

Duke Scholars

Author Sean Pokorney Medicine, Cardiology

Author Christopher Bull Granger Medicine, Cardiology