The Correlation between Common Variable Immunodeficiency and Atrial Fibrillation: Cardiac Implantable Electronic Devices‐associated infection by Stenotrophomonas maltophilia: A case report

Abstract

BackgroundCommon variable immunodeficiency (CVID) is associated with systemic infections and autoimmune diseases which may elicit and perpetuate atrial fibrillation via inflammatory and oxidative mechanisms. CVID patients with early‐onset atrial fibrillation (AF) and chronic heart failure (CHF) are refractory to standardized cardiac ablation and frequently need sophisticated cardiac resynchronization therapy. Moreover, CVID‐CHF patients with cardiac implantable electronic devices (CIEDs) are vulnerable to opportunistic infection, especially Stenotrophomonas maltophilia bacteremia, which has high resistance to a variety of empirical antibiotics against gram negative bacteremia.Case presentation31 year‐old female with a past medical history of chronic refractory AF, CHF, thyroid cancer, non‐Hodgkin lymphoma, and factor V deficiency presented to the hospital with a fever of 104.0F for 2 days after recent dual‐chamber biventricular defibrillator replacement 2 weeks ago. 2 months ago, the patient was diagnosed with CVID due to recurrent cardiopulmonary infections. Upon this admission, the patient’s blood culture demonstrated S. maltophilia which was likely from the complications of CIEDs placement.ConclusionEarly‐onset Atrial fibrillation in young population may be a feature of CVID. Early recognition of CVID in these patients, especially with comorbidity of CHF, can mitigate the progression of AF with antioxidants as well as promptly identify and manage CIEDs‐associated infections, such as S. maltophilia.Figure 1