Arrhythmias & electrophysiology
Chlorhexidine vs Povidone-Iodine Alcohol Solutions for Cardiac Implantable Electronic Devices: A Prospective Randomized Study
Primary result · Device-related infectionResult — go to the resultAdjusted subhazard ratio 0.75 95% CI 0.48–1.20Authors' conclusion
The study did not demonstrate a significant reduction in infection rates with alcoholic chlorhexidine compared with alcoholic povidone-iodine in patients undergoing cardiac resynchronization device implantation. Both antiseptics showed similar rates of major infectious and noninfectious events.
Study context
- Population
- Patients undergoing cardiac resynchronization therapy (CRT) (implantation, upgrade or replacement) pacemaker or defibrillator implantation
- Participants
- 2,272 patients
- Comparison
- 2% alcoholic chlorhexidine vs alcoholic povidone-iodine skin antisepsis
- Chlorhexidinen = 1,143
- Povidone-iodinen = 1,129reference
- Primary endpoint
- Local or systemic device-related infection
- Follow-up
- 24-month follow-up
Methodological detailsmulticentre, open-label, blinded outcome adjudication
- Multicentre
- Open-label
- Blinded outcome adjudication
Primary result
Device-related infection · 24 months
Adjusted subhazard ratio
0.75
95% CI 0.48–1.20
P = 0.23
By group
Chlorhexidine vs Povidone-iodine
adjusted subhazard ratio 0.75 (95% CI 0.48–1.20); P = 0.23
As reported in the abstract
Secondary outcomes
| Outcome | Chlorhexidine | Povidone-iodine | Subhazard ratio (95% CI) | |
|---|---|---|---|---|
| Major CV events | 31.5% | 31.3% | 1.01 (0.87–1.17) | |
| 0.512Subhazard ratio (log scale) |
Safety
Noninfectious local side effects
- Noninfectious local side effects
- 12.9% vs 13.3%
Original publication
Chlorhexidine vs Povidone-Iodine Alcohol Solutions for Cardiac Implantable Electronic Devices: A Prospective Randomized Study. J Am Coll Cardiol. Published 20 January 2026. doi:10.
Summarised from the published abstract; every number is checked against it