To describe current real-world utilization of mcfDNA testing for CV infections using a multi-center retrospective registry. We will develop multi-center REDCap database of mcfDNA use in valvular IE and/or CIED lead infections and summarize patient demographics and clinical characteristics of IE and CIED lead infection cases. We will assess common scenarios/indications for which mcfDNA is sent and timing of the test. Clinically relevant microbiological yield of mcfDNA in IE and/or CIED lead infections will be described.

To identify clinical predictors where mcfDNA outperforms CMT. We will assess clinical characteristics of patients with IE and CIED lead infection in whom mcfDNA has higher microbiologic yield compared to CMT. We will develop a prediction model/scoring system to identify subgroup of patients in whom mcfDNA should be sent early (after 48 hours of negative CMT).

To analyze clinical impact of mcfDNA testing in patients with valvular IE and/or CIED lead infections. We will classify cases as having Positive vs. Negative vs. Neutral impact using pre-specified definitions and assess predictor of positive clinical impact.