ArticleCirculation. Arrhythmia and electrophysiology2020
Cost-Effectiveness of an Antibacterial Envelope for Cardiac Implantable Electronic Device Infection Prevention in the US Healthcare System From the WRAP-IT Trial.
Article in Circulation. Arrhythmia and electrophysiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02277990 (Cardiac Implantable Electronic Device), which is not on this map. Cited by 29 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Cardiac Implantable Electronic Device (CIED) Antibiotic Envelope Infection Prevention Trial
Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 62 citations in OpenAlex.
- Cost-effectiveness of an intraoperative antibacterial envelope in preventing cardiac implantable device-associated infections: a systematic review.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Pooled it
- Antibiotic eluting envelopes: evidence, technology, and defining high-risk populations.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2021Trial
- Left Atrial Appendage Occlusion Device Infection: A Rare Case Report and Literature Review.Cureus · 2026Article
- Precision Prevention in CIED Infection: Interpreting the Signal Beyond the Pooled Estimate.Korean circulation journal · 2026Article
- Efficacy of Antimicrobial Envelopes in Preventing Cardiac Implantable Electronic Device Infection: Systematic Review and Meta-Analysis.Korean circulation journal · 2026Article
- Evidence-Based Strategies for the Prevention of Cardiac Implantable Electronic Device Infections: An Up-to-Date Narrative Review.Medicina (Kaunas, Lithuania) · 2026Review
- Validation of the PADIT (prevention of arrhythmia device infection trial) risk score for infection and infection subtypes.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Article
- Cost-Effectiveness of an Antibacterial Envelope in Patients at High Risk of Cardiac Implantable Electronic Device Infection in the Australian Public Healthcare System.Journal of arrhythmia · 2026Article
- Cost-Effectiveness of an Absorbable Antibacterial Envelope for Infection Control in Cardiac Implantable Electronic Device Procedures in Spain.Journal of health economics and outcomes research · 2026Article
- Intervention studies and antimicrobial resistance in Italy: An overview of the latest evidence.Journal of global antimicrobial resistance · 2026Review
- Erratum: Cost-Effectiveness of an Absorbable Antibacterial Envelope for Infection Control in Cardiac Implantable Electronic Device Procedures in Spain.Journal of health economics and outcomes research · 2026Article
- Artificial Intelligence and the Future of Cardiac Implantable Electronic Devices: Diagnostics, Monitoring, and Therapy.Journal of clinical medicine · 2025Review
- Cardiac implantable electronic device upgrades and downgrades: a Clinical Consensus Statement of the European Heart Rhythm Association (EHRA) of the ESC, the Asia Pacific Heart Rhythm Association (APHRS), Canadian Heart Rhythm Society (CHRS), Heart Rhythm Society (HRS), and the Latin American Heart Rhythm Society (LAHRS).Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- Quantitative Microbial Cell-Free DNA Sequencing From Plasma: A Potential Biomarker for the Diagnosis of Staphylococcal Infection of Cardiac Implantable Electronic Devices.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Continuous, In Situ Targeted, Ultrahigh-Concentration Antibiotics for Infections from Cardiac Implantable Electronic Devices: The First Taiwan Case Series.Acta Cardiologica Sinica · 2025Article
- Synthesis, radiolabeling, and biological evaluation of methyl 6-deoxy-6-[RSC advances · 2025Article
- Delayed delivery of antibiotics by ultrasound-mediated rupture of polylactic acid pockets: In vitro and in vivo studies.PloS one · 2025Article
- Device infection in patients undergoing pacemaker or defibrillator surgery: risk stratification using the PADIT score.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2024Article
- Mortality and Costs of Cardiac Implantable Electronic Device (CIED) Infections According to the Therapeutic Approach: A Single-Center Cohort Study.Microorganisms · 2024Article
- The BLISTER Score: A Novel, Externally Validated Tool for Predicting Cardiac Implantable Electronic Device Infections, and Its Cost-Utility Implications for Antimicrobial Envelope Use.Circulation. Arrhythmia and electrophysiology · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
26 authors at 20 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn the WRAP-IT trial (Worldwide Randomized Antibiotic Envelope Infection Prevention), adjunctive use of an absorbable antibacterial envelope resulted in a 40% reduction of major cardiac implantable electronic device infection without increased risk of complication in 6983 patients undergoing cardiac implantable electronic device revision, replacement, upgrade, or initial cardiac resynchronization therapy defibrillator implant. There is limited information on the cost-effectiveness of this strategy. As a prespecified objective, we evaluated antibacterial envelope cost-effectiveness compared with standard-of-care infection prevention strategies in the US healthcare system.
methodsA decision tree model was used to compare costs and outcomes of antibacterial envelope (TYRX) use adjunctive to standard-of-care infection prevention versus standard-of-care alone over a lifelong time horizon. The analysis was performed from an integrated payer-provider network perspective. Infection rates, antibacterial envelope effectiveness, infection treatment costs and patterns, infection-related mortality, and utility estimates were obtained from the WRAP-IT trial. Life expectancy and long-term costs associated with device replacement, follow-up, and healthcare utilization were sourced from the literature. Costs and quality-adjusted life years were discounted at 3%. An upper willingness-to-pay threshold of $150 000 per quality-adjusted life year was used to determine cost-effectiveness, in alignment with the American College of Cardiology/American Heart Association practice guidelines and as supported by the World Health Organization and contemporary literature.
resultsThe base case incremental cost-effectiveness ratio of the antibacterial envelope compared with standard-of-care was $112 603/quality-adjusted life year. The incremental cost-effectiveness ratio remained lower than the willingness-to-pay threshold in 74% of iterations in the probabilistic sensitivity analysis and was most sensitive to the following model inputs: infection-related mortality, life expectancy, and infection cost.
conclusionsThe absorbable antibacterial envelope was associated with a cost-effectiveness ratio below contemporary benchmarks in the WRAP-IT patient population, suggesting that the envelope provides value for the US healthcare system by reducing the incidence of cardiac implantable electronic device infection. Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02277990.
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