The effect of an antibacterial envelope on cardiac implantable device-related infection — A real-world analysis from a tertiary center

BACKGROUND: Infections related to cardiac implantable electronic devices (CIED) are associated with significant morbidity and mortality. Antibiotic-eluting envelopes have been introduced as a technology to prevent CIED infections. The aim of this study was to evaluate the effectiveness of the antiba...

Full description

Saved in:
Bibliographic Details
Main Authors: Nadine Molitor, Vera Graup, Daniel Hofer, Pascal Rüegg, Deniza Avdi, Ardan M. Saguner, Alexander Breitenstein, Jan Steffel
Format: Article
Language:English
Published: Via Medica 2025-06-01
Series:Cardiology Journal
Subjects:
Online Access:https://journals.viamedica.pl/cardiology_journal/article/view/100458
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849230362177175552
author Nadine Molitor
Vera Graup
Daniel Hofer
Pascal Rüegg
Deniza Avdi
Ardan M. Saguner
Alexander Breitenstein
Jan Steffel
author_facet Nadine Molitor
Vera Graup
Daniel Hofer
Pascal Rüegg
Deniza Avdi
Ardan M. Saguner
Alexander Breitenstein
Jan Steffel
author_sort Nadine Molitor
collection DOAJ
description BACKGROUND: Infections related to cardiac implantable electronic devices (CIED) are associated with significant morbidity and mortality. Antibiotic-eluting envelopes have been introduced as a technology to prevent CIED infections. The aim of this study was to evaluate the effectiveness of the antibacterial envelope in the real-world population of a tertiary center. METHODS: This cohort study includes consecutively enrolled patients undergoing a device procedure from 01/2014 to 12/2020 at the University Hospital in Zurich. During period A (01/2014-12/2019) antibacterial envelopes were not used, whereas during period B (01/2020-12/2020) antibacterial envelopes were used in all device interventions. Follow-up was conducted by assessing all available patient records from patient visits and hospitalization. RESULTS: 1757 patients (male 70.5%, mean age 67.1 ± 16 years), were analyzed during a follow-up of 24 months. In 302 patients (17.2%) an antibacterial envelope was used. The overall occurrence of a device infection was low (n = 15, 0.85%). Factors that were associated with the incidence of an infection were not undergoing a primary implantation procedure (p = 0.024) and a CRT-P/D intervention (p = 0.022). There was no difference in the rate of infection between patients in whom a bacterial envelope was implanted vs. those in whom it was not used (0.6 vs. 0.9%, p = 0.693). CONCLUSION: In a contemporary cohort of consecutive, unselected patients undergoing a device intervention at a large tertiary care center, the rate of device infection was low and not significantly different with vs. without the use of an antibacterial envelope. The data have important practical as well as economic implications for physicians performing such procedures.
format Article
id doaj-art-b4d8799989ab43cab45ac0d3448a1eeb
institution Kabale University
issn 1897-5593
1898-018X
language English
publishDate 2025-06-01
publisher Via Medica
record_format Article
series Cardiology Journal
spelling doaj-art-b4d8799989ab43cab45ac0d3448a1eeb2025-08-21T06:14:03ZengVia MedicaCardiology Journal1897-55931898-018X2025-06-0132310.5603/cj.100458The effect of an antibacterial envelope on cardiac implantable device-related infection — A real-world analysis from a tertiary centerNadine Molitor0https://orcid.org/0000-0003-2544-7354Vera Graup1Daniel Hofer2Pascal Rüegg3Deniza Avdi4Ardan M. Saguner5Alexander Breitenstein6Jan Steffel7Department of Cardiology, University Heart Center, University Hospital Zurich, SwitzerlandDepartment of Cardiology, University Heart Center, University Hospital Zurich, SwitzerlandDepartment of Cardiology, University Heart Center, University Hospital Zurich, SwitzerlandDepartment of Cardiology, University Heart Center, University Hospital Zurich, SwitzerlandDepartment of Cardiology, University Heart Center, University Hospital Zurich, SwitzerlandDepartment of Cardiology, University Heart Center, University Hospital Zurich, SwitzerlandDepartment of Cardiology, University Heart Center, University Hospital Zurich, SwitzerlandDepartment of Cardiology, University Heart Center, University Hospital Zurich, SwitzerlandBACKGROUND: Infections related to cardiac implantable electronic devices (CIED) are associated with significant morbidity and mortality. Antibiotic-eluting envelopes have been introduced as a technology to prevent CIED infections. The aim of this study was to evaluate the effectiveness of the antibacterial envelope in the real-world population of a tertiary center. METHODS: This cohort study includes consecutively enrolled patients undergoing a device procedure from 01/2014 to 12/2020 at the University Hospital in Zurich. During period A (01/2014-12/2019) antibacterial envelopes were not used, whereas during period B (01/2020-12/2020) antibacterial envelopes were used in all device interventions. Follow-up was conducted by assessing all available patient records from patient visits and hospitalization. RESULTS: 1757 patients (male 70.5%, mean age 67.1 ± 16 years), were analyzed during a follow-up of 24 months. In 302 patients (17.2%) an antibacterial envelope was used. The overall occurrence of a device infection was low (n = 15, 0.85%). Factors that were associated with the incidence of an infection were not undergoing a primary implantation procedure (p = 0.024) and a CRT-P/D intervention (p = 0.022). There was no difference in the rate of infection between patients in whom a bacterial envelope was implanted vs. those in whom it was not used (0.6 vs. 0.9%, p = 0.693). CONCLUSION: In a contemporary cohort of consecutive, unselected patients undergoing a device intervention at a large tertiary care center, the rate of device infection was low and not significantly different with vs. without the use of an antibacterial envelope. The data have important practical as well as economic implications for physicians performing such procedures.https://journals.viamedica.pl/cardiology_journal/article/view/100458antibacterial envelopecardiac implantable electronic device
spellingShingle Nadine Molitor
Vera Graup
Daniel Hofer
Pascal Rüegg
Deniza Avdi
Ardan M. Saguner
Alexander Breitenstein
Jan Steffel
The effect of an antibacterial envelope on cardiac implantable device-related infection — A real-world analysis from a tertiary center
Cardiology Journal
antibacterial envelope
cardiac implantable electronic device
title The effect of an antibacterial envelope on cardiac implantable device-related infection — A real-world analysis from a tertiary center
title_full The effect of an antibacterial envelope on cardiac implantable device-related infection — A real-world analysis from a tertiary center
title_fullStr The effect of an antibacterial envelope on cardiac implantable device-related infection — A real-world analysis from a tertiary center
title_full_unstemmed The effect of an antibacterial envelope on cardiac implantable device-related infection — A real-world analysis from a tertiary center
title_short The effect of an antibacterial envelope on cardiac implantable device-related infection — A real-world analysis from a tertiary center
title_sort effect of an antibacterial envelope on cardiac implantable device related infection a real world analysis from a tertiary center
topic antibacterial envelope
cardiac implantable electronic device
url https://journals.viamedica.pl/cardiology_journal/article/view/100458
work_keys_str_mv AT nadinemolitor theeffectofanantibacterialenvelopeoncardiacimplantabledevicerelatedinfectionarealworldanalysisfromatertiarycenter
AT veragraup theeffectofanantibacterialenvelopeoncardiacimplantabledevicerelatedinfectionarealworldanalysisfromatertiarycenter
AT danielhofer theeffectofanantibacterialenvelopeoncardiacimplantabledevicerelatedinfectionarealworldanalysisfromatertiarycenter
AT pascalruegg theeffectofanantibacterialenvelopeoncardiacimplantabledevicerelatedinfectionarealworldanalysisfromatertiarycenter
AT denizaavdi theeffectofanantibacterialenvelopeoncardiacimplantabledevicerelatedinfectionarealworldanalysisfromatertiarycenter
AT ardanmsaguner theeffectofanantibacterialenvelopeoncardiacimplantabledevicerelatedinfectionarealworldanalysisfromatertiarycenter
AT alexanderbreitenstein theeffectofanantibacterialenvelopeoncardiacimplantabledevicerelatedinfectionarealworldanalysisfromatertiarycenter
AT jansteffel theeffectofanantibacterialenvelopeoncardiacimplantabledevicerelatedinfectionarealworldanalysisfromatertiarycenter
AT nadinemolitor effectofanantibacterialenvelopeoncardiacimplantabledevicerelatedinfectionarealworldanalysisfromatertiarycenter
AT veragraup effectofanantibacterialenvelopeoncardiacimplantabledevicerelatedinfectionarealworldanalysisfromatertiarycenter
AT danielhofer effectofanantibacterialenvelopeoncardiacimplantabledevicerelatedinfectionarealworldanalysisfromatertiarycenter
AT pascalruegg effectofanantibacterialenvelopeoncardiacimplantabledevicerelatedinfectionarealworldanalysisfromatertiarycenter
AT denizaavdi effectofanantibacterialenvelopeoncardiacimplantabledevicerelatedinfectionarealworldanalysisfromatertiarycenter
AT ardanmsaguner effectofanantibacterialenvelopeoncardiacimplantabledevicerelatedinfectionarealworldanalysisfromatertiarycenter
AT alexanderbreitenstein effectofanantibacterialenvelopeoncardiacimplantabledevicerelatedinfectionarealworldanalysisfromatertiarycenter
AT jansteffel effectofanantibacterialenvelopeoncardiacimplantabledevicerelatedinfectionarealworldanalysisfromatertiarycenter