{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T09:08:41Z","timestamp":1775725721468,"version":"3.50.1"},"reference-count":9,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T00:00:00Z","timestamp":1741651200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T00:00:00Z","timestamp":1741651200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cardiac implantable electronic device (CIED) infections are a serious complication associated with significant morbidity, mortality, and healthcare costs. Despite guideline recommendations for complete device removal, disparities in healthcare access and resource availability between urban and rural settings may influence patient outcomes. This study aims to evaluate rural\u2013urban disparities in the management and outcomes of patients hospitalized with CIED infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective cohort analysis was conducted using the National Readmissions Database (NRD) from 2016 to 2021. Patients aged \u2265\u200918 years hospitalized with CIED infections were identified using ICD\u201010 codes. Hospital location was categorized as urban or rural based on the Urban Influence Codes. Baseline characteristics, complications, and outcomes were compared using chi\u2010square and\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests, and a multivariable logistic regression model was employed to assess the independent association of hospital settings with transvenous lead removal (TLR) utilization.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 288,402 patients were hospitalized for CIED infections, with 94.9% treated in urban hospitals and 5.1% in rural hospitals. Urban hospital patients had a higher prevalence of key comorbidities, including heart failure, valvular heart disease, atrial fibrillation and peripheral vascular disorders. In\u2010hospital mortality was significantly higher in urban hospitals (6.2% vs. 4.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) likely due to higher burden of comorbidities and higher rates of acute complications such as stroke (3.1% vs. 1.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) and systemic embolism (1.4% vs. 0.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). TLR was more frequently performed in urban hospitals (20.1% vs. 9.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01), with rural hospitals exhibiting 59% lower odds of receiving TLR (OR: 0.41, 95% CI: 0.36\u20130.47,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). TLR was associated with reduced in\u2010hospital mortality, 30\u2010day mortality, and 30\u2010day readmission rates across both hospital settings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study highlights significant rural\u2013urban disparities in CIED infection management. Despite rural hospitals admitting patients with a lower comorbidity burden, TLR utilization was significantly lower, potentially due to limited access to specialized expertise and procedural resources. Given TLR's association with improved survival and reduced readmissions, regardless of the hospital setting, targeted interventions are needed to enhance access to specialized care in rural settings. Further research is warranted to explore strategies for bridging these disparities and optimizing CIED infection outcomes nationwide.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.16637","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T03:02:07Z","timestamp":1741748527000},"page":"1068-1072","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Urban\u2010Rural Differences in the Outcomes of Patients Hospitalized for Cardiac Implantable Electronic Devices Infection in the United States"],"prefix":"10.1111","volume":"36","author":[{"given":"Siddharth","family":"Agarwal","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zain Ul Abideen","family":"Asad","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Oklahoma Health Sciences Center Oklahoma City Oklahoma USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9804-898X","authenticated-orcid":false,"given":"Muhammad Bilal","family":"Munir","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine University of California Davis Sacramento California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin Z.","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Cleveland Clinic Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel C.","family":"DeSimone","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester Minnesota USA"},{"name":"Division of Infectious Diseases, Department of Internal Medicine Mayo Clinic Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8420-4670","authenticated-orcid":false,"given":"Christopher V.","family":"DeSimone","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9560-1102","authenticated-orcid":false,"given":"Abhishek J.","family":"Deshmukh","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,11]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.192665"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2011.05.015"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11113063"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2017.09.001"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2021.12.057"},{"key":"e_1_2_11_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2021.12.023"},{"key":"e_1_2_11_7_1","unstructured":"Healthcare Cost and Utilization Project Overview of the Nationwide Readmissions Database (NRD) accessed October 30 2024 https:\/\/www.hcup-us.ahrq.gov\/nrdoverview.jsp."},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euae308"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2019.07.095"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.16637","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jce.16637","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.16637","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T10:05:49Z","timestamp":1772964349000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jce.16637"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,11]]},"references-count":9,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1111\/jce.16637"],"URL":"https:\/\/doi.org\/10.1111\/jce.16637","archive":["Portico"],"relation":{},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"value":"1045-3873","type":"print"},{"value":"1540-8167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,11]]},"assertion":[{"value":"2025-02-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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