Arrhythmias & electrophysiologyRandomised controlled trial
Chlorhexidine vs Povidone-Iodine Alcohol Solutions for Cardiac Implantable Electronic Devices
- Randomised controlled trial
- multicentre
- open-label
- blinded outcome adjudication
Authors' 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
Primary result
Device-related infection · 24 months
Adjusted subhazard ratio
0.75
95% CI 0.48–1.20
P = 0.23
By group
As reported in the abstract
Secondary outcomes
Major CV events
subhazard ratio 1.01 (0.87–1.17)
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. J Am Coll Cardiol. Published 20 January 2026. doi:10.1016/j.jacc.2025.10.042
Summarised from the published abstract; every number is checked against it