Cardiac implantable electronic device infection – what’s new after the BLISTER study?

<ns3:p>Cardiac implantable electronic device (CIED) infections pose a significant challenge, with occurrence rates of 1-4% post-implantation and a 50% increased mortality risk within three years. Risk factors can expose 22-56% of patients to an elevated risk of infection, and device removal increases annual mortality by 25%. Cost analysis reveals substantial financial burdens on healthcare, averaging €7,909.58 per infection and €11,278.74 for CRT-D infections in Poland. The BLISTER risk score, based on blood results, procedure time, immunosuppression, age, intervention type, and repeat procedures, improves patient risk stratification. Compared to the PADIT score, BLISTER offers superior infection risk reduction and cost-effectiveness, making antibiotic envelopes economically justifiable. Research indicates TYRX envelopes significantly reduce infections, with BLISTER showing a greater risk reduction (30%) at a lower cost per QALY (18,446). This review examines strategies to mitigate CIED infections, focusing on both biological and non-biological envelopes for fibrous capsule formation, thereby preventing local inflammation and reducing complications during device replacement.</ns3:p>