Clinically overt infections and markers of inflammation in patients admitted to Emergency Department due to high-energy discharges of implantable cardioverter-defibrillator

Introduction. Overt infection is a reversible factor that may contribute to the occurrence of high-energy interventions of implanted cardioverter-defibrillators (ICD). Aim. To assess the incidence of clinically overt infections and the analysis of C-reactive protein (CRP) concentration in patients admitted to Emergency Department (ED) after ICD shock. Material and methods. A total of 167 patients aged 63.2 ± 12.1 admitted to ED due to high-energy therapy from ICD in whom CRP level was measured. A retrospective analysis of the correlation of CRP concentration on admission and the next morning from gender, age, the adequate or inadequate character of the shocks, the number of shocks and clinical overt infections was performed. Results. Infection was recognized in 16 (9.6%) patients. CRP level on admission (CRP-1) was 11.0 ± 34.7 mg/dL and was elevated in 46 patients (27.5%). In the subgroup of 53 patients with the second measurement, CRP significantly increased. In multivariate analysis an increase in CRP was related with 1 electroshock in patients without overt infection or at least 5 electroshocks in patients with ≥ 2 shock. Conclusions. 1. The increased CRP concentration on admission to ED after ICD highenergy intervention is significantly more common than clinically recognized overt infection. 2. The increased level of CRP in patients admitted to ED due to ICD shocks may be related to infection or may be secondary to the multiple shocks.