Expected Benefits From Antibacterial Envelope in Different CIED Patient Populations

Antibacterial envelope has proven to be safe and effective in reducing cardiac implantable electronic device (CIED) infection. Recently, its role in pocket healing process has also started to be studied, showing additional potential benefits for the patients. Risk scores such as the PADIT and the BLISTER ones have been developed to stratify patients at higher risk of developing CIED infections, but their use is still limited. There is a need for clear and concise practical guidance and scores for the correct stratification of patients at risk to develop CIED infections, to apply an effective preventive strategy. This article examines the most recent findings on the effectiveness of antibacterial envelopes in preventing CIED infections and introduces the latest concept of pocket stabilization. Additionally, patient populations that could potentially benefit from antibacterial envelope for both indications are provided based on the agreement of an expert panel made up of 16 European electrophysiologists from high-volume centers. Future studies will have to evaluate the strength of those proposals and the benefits of pocket stabilization in the long-term.