Arrhythmias & electrophysiologyCohort study
Device Infection Using Chlorhexidine Irrigation vs an Antibacterial Envelope
- retrospective observational study
- propensity score matching
Authors' conclusion
In high-risk procedures, CHG irrigation resulted in a similar risk of CIED-related infection as treatment with an ABE, without any adverse events. The lower cost of CHG and widespread availability could result in more patients being treated, thus extending the benefits to patients with a lower risk of infection.
Study context
- Population
- Patients undergoing high-risk cardiac implantable electronic device (CIED) interventions (generator change, device upgrade, lead/pocket revision, cardiac resynchronization device implantation) between 2018 and 2024, in whom either chlorhexidine gluconate (CHG) irrigation or antibacterial envelope (ABE) was usedafter propensity score matching, a total of 714 patients analyzed
- Participants
- 1,749 patients
- Exposure
- chlorhexidine gluconate pocket irrigation vs antibacterial envelope
- CHGn = 1,118
Main finding
CIED-related infection · median follow-up of 459 days (Q1-Q3: 192-852 days)
Hazard ratio
0.89
95% CI 0.3–2.66
log-rank P = 0.83
By group
CHG vs ABE
HR 0.89 (95% CI 0.3–2.66); log-rank P = 0.83
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | CHG | ABE | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| CIED-related infection, propensity score-matched cohort | 1.1% | 1.1% | 0.97 (0.24–3.86) | log-rank P = 0.96 | |
| 0.20.5125Hazard ratio (log scale) |
- CIED-related infection, propensity score-matched cohort: matched cohort of 714 patients, without statistically significant differences in baseline characteristics
Safety
Adverse events associated with CHG irrigation
- No adverse events associated with CHG irrigation occurred
Original publication
Device Infection Using Chlorhexidine Irrigation vs an Antibacterial Envelope. JACC Clin Electrophysiol. Published 19 March 2026. doi:10.1016/j.jacep.2026.01.035
Summarised from the published abstract; every number is checked against it