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18 Supplementary data

Supplementary data are available at European Heart Journal online.

19 Data availability

No new data were generated or analysed in support of this research.

20 Author information

Author/Task Force Member Affiliations: Nina Ajmone Marsan, Leiden University Medical Center, Leiden, Netherlands; Suzanne de Waha, Heart Center Leipzig at University of Leipzig, Leipzig, Germany; Nikolaos Bonaros, Medical University of Innsbruck, Innsbruck, Austria and University Hospital Innsbruck, Innsbruck, Austria; Margarita Brida, Medical Faculty University of Rijeka, Rijeka, Croatia and Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton & Harefield Hospitals, London, United Kingdom; Haran Burri, University Hospital of Geneva, Geneva, Switzerland; Stefano Caselli, Hirslanden Klinik im Park, Zurich, Switzerland and University Heart Center, University Hospital Zurich, Zurich, Switzerland; Torsten Doenst, Friedrich-Schiller-University Jena, University Hospital, Jena, Germany; Stephane Ederhy, Hopital Saint-Antoine, Paris, France and Unité de cardio-oncologie, UNICO-GRECO, Hopital Saint-Antoine, Paris, France and Groupe de recherche clinique en cardio-oncologie, GRC n°27, Hopital Saint-Antoine, Paris, France; Paola Anna Erba, University of Milan Bicocca, Milan, Italy and Nuclear Medicine Department, ASST – Ospedale Papa Giovanni XXIII, Bergamo, Italy and Medical Imaging Center, Department of Nuclear Medicine & Molecular Imaging, University Medical Center Groningen, Groningen, Netherlands; Dan Foldager, ESC Patient Forum, Sophia Antipolis, France; Emil L. Fosbøl, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark; Jan Kovac, University of Leicester, Leicester, United Kingdom and RRCV Glenfield, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; Carlos A. Mestres, The University of the Free State, Bloemfontein, South Africa and Cardiac Surgery, University Hospital Zurich, Zurich, Switzerland; Owen I. Miller, Evelina London Children’s Hospital, London, United Kingdom and Department of Women and Children’s Health, Kings College London, London, United Kingdom; Jose M. Miro, Hospital Clinic - IDIBAPS, Barcelona, Spain and Faculty of Medicine, University of Barcelona, Barcelona, Spain and Centro de Investigación Biomédica en Red Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain; Michal Pazdernik, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic; Maria Nazarena Pizzi, Vall d ́Hebron University Hospital, Barcelona, Spain; Eduard Quintana, Hospital Clínic de Barcelona, Barcelona, Spain and Departament de Cirurgia i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, University of Barcelona, Barcelona, Spain; Trine Bernholdt Rasmussen, Herlev and Gentofte University Hospital, Hellerup, Denmark and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Arsen D. Ristić, University Clinical Center of Serbia, Belgrade, Serbia and Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Josep Rodés-Cabau, Quebec Heart and Lung Institute, Laval University, Quebec, Canada and Research and Innovation, Clínic Barcelona, Barcelona, Spain; Alessandro Sionis, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain and Universitat Autònoma de Barcelona, Barcelona, Spain; Liesl Joanna Zühlke, Francie van Zijl Drive Parowvallei, Cape Town; PO Box 19070, Cape Town, South Africa and Division of Paediatric Cardiology, Department of Paediatrics, Institute of Child Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.

Obtaining at least three sets of blood cultures is recommended before prompt initiation of empirical antibiotic therapy for CIED infection, covering methicillin-resistant staphylococci and Gram-negative bacteria. I C If CIED reimplantation is indicated after extraction for CIED-related IE, it is recommended to be performed at a site distant from the previous generator, as late as possible, once signs and symptoms of infection have abated, and until blood cultures are negative for at least 72 h in the absence of vegetations, and negative for at least 2 weeks if vegetations were visualized. I C Removal of CIED after a single positive blood culture, with no other clinical evidence of infection, is not recommended. III C Recommendations for the surgical treatment of right-sided infective endocarditis Surgery is recommended in patients with right-sided IE who are receiving appropriate antibiotic therapy for the following scenarios:

Right ventricular dysfunction secondary to acute severe tricuspid regurgitation non-responsive to diuretics. I B Persistent vegetation with respiratory insufficiency requiring ventilatory support after recurrent pulmonary emboli. I B Large residual tricuspid vegetations (>20 mm) after recurrent septic pulmonary emboli. I C Patients with simultaneous involvement of left-heart structures. I C Recommendations for the use of antithrombotic therapy in infective endocarditis Interruption of antiplatelet or anticoagulant therapy is recommended in the presence of major bleeding (including intracranial haemorrhage). I C Thrombolytic therapy is not recommended in patients with IE. III C © ESC 2023 [18F]FDG-PET, 18F-fluorodeoxyglucose positron emission tomography; AVB, atrioventricular block; CAD, coronary artery disease; CHD, congenital heart disease; CIED, cardiovascular implanted electronic device; CT, computed tomography; CTA, computed tomography angiography; HF, heart failure; HLAR, high-level aminoglycoside resistance; IE, infective endocarditis; i.m., intramuscular; i.v., intravenous; MRA, magnetic resonance angiography; MRI, magnetic resonance imaging; NVE, native valve endocarditis; PET, positron emission tomography; PVE, prosthetic valve endocarditis; PWID, people who inject drugs; TOE, transoesophageal echocardiography; TTE, transthoracic echocardiography. aClass of recommendation. bLevel of evidence. Downloaded from academic.oup.com/eurheartj/article/44/39/3948/7243107 by guest on 07 October 2026