{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:42:02Z","timestamp":1787499722998,"version":"build-2736575974"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Current understanding of the impact of cardiac implantable electronic device (CIED) infection is based on retrospective analyses from medical records or administrative claims data. The WRAP-IT (Worldwide Randomized Antibiotic Envelope Infection Prevention Trial) offers an opportunity to evaluate the clinical and economic impacts of CIED infection from the hospital, payer, and patient perspectives in the US healthcare system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This was a prespecified, as-treated analysis evaluating outcomes related to major CIED infections: mortality, quality of life, disruption of CIED therapy, healthcare utilization, and costs. Payer costs were assigned using medicare fee for service national payments, while medicare advantage, hospital, and patient costs were derived from similar hospital admissions in administrative datasets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Major CIED infection was associated with increased all-cause mortality (12-month risk-adjusted hazard ratio, 3.41 [95% CI, 1.81\u20136.41];\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001), an effect that sustained beyond 12 months (hazard ratio through all follow-up, 2.30 [95% CI, 1.29\u20134.07];\n                      <jats:italic>P<\/jats:italic>\n                      =0.004). Quality of life was reduced (\n                      <jats:italic>P<\/jats:italic>\n                      =0.004) and did not normalize for 6 months. Disruptions in CIED therapy were experienced in 36% of infections for a median duration of 184 days. Mean costs were $55\u2009547\u00b1$45\u2009802 for the hospital, $26\u2009867\u00b1$14\u2009893, for medicare fee for service and $57\u2009978\u00b1$29\u2009431 for Medicare Advantage (mean hospital margin of \u2212$30\u2009828\u00b1$39\u2009757 for medicare fee for service and \u2212$6055\u00b1$45\u2009033 for medicare advantage). Mean out-of-pocket costs for patients were $2156\u00b1$1999 for medicare fee for service, and $1658\u00b1$1250 for medicare advantage.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This large, prospective analysis corroborates and extends understanding of the impact of CIED infections as seen in real-world datasets. CIED infections severely impact mortality, quality of life, healthcare utilization, and cost in the US healthcare system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration:<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      Unique Identifier: NCT02277990\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circep.119.008280","type":"journal-article","created":{"date-parts":[[2020,4,12]],"date-time":"2020-04-12T18:35:22Z","timestamp":1586716522000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":74,"title":["Impact of Cardiac Implantable Electronic Device Infection"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8905-9233","authenticated-orcid":false,"given":"Bruce L.","family":"Wilkoff","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine and Heart and Vascular Institute, Cleveland Clinic, OH (B.L.W., K.G.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9820-4815","authenticated-orcid":false,"given":"Giuseppe","family":"Boriani","sequence":"additional","affiliation":[{"name":"Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy (G.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8003-7254","authenticated-orcid":false,"given":"Suneet","family":"Mittal","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Section of Electrophysiology, Valley Health System, Ridgewood, NJ (S.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanne E.","family":"Poole","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Washington School of Medicine, Seattle (J.E.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Kennergren","sequence":"additional","affiliation":[{"name":"The Sahlgrenska Academy, University of G\u00f6teborg, Sweden (C.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Ralph","family":"Corey","sequence":"additional","affiliation":[{"name":"Department of Medicine, Duke Clinical Research Institute, Durham, NC (G.R.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"Love","sequence":"additional","affiliation":[{"name":"Maine Medical Partners, Maine Medical Center, Portland (J.C.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph","family":"Augostini","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Ohio State University, Columbus (R.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svein","family":"Faerestrand","sequence":"additional","affiliation":[{"name":"Department of Heart Disease, University of Bergen and Haukeland University Hospital, Norway (S.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherman S.","family":"Wiggins","sequence":"additional","affiliation":[{"name":"ARK-LA-TEX Cardiology, Christus Highland Hospital, Shreveport, LA (S.S.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1216-7580","authenticated-orcid":false,"given":"Jeff S.","family":"Healey","sequence":"additional","affiliation":[{"name":"Population Health Research Institute, McMaster University, ON, Canada (J.S.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8995-3024","authenticated-orcid":false,"given":"Reece","family":"Holbrook","sequence":"additional","affiliation":[{"name":"Cardiac Rhythm &amp; Heart Failure (CRHF) Therapy Development and Clinical Research, Medtronic, Mounds View, MN (R.H., J.D.L., D.R.L., S.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9584-610X","authenticated-orcid":false,"given":"Jeffrey D.","family":"Lande","sequence":"additional","affiliation":[{"name":"Cardiac Rhythm &amp; Heart Failure (CRHF) Therapy Development and Clinical Research, Medtronic, Mounds View, MN (R.H., J.D.L., D.R.L., S.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3340-1292","authenticated-orcid":false,"given":"Daniel R.","family":"Lexcen","sequence":"additional","affiliation":[{"name":"Cardiac Rhythm &amp; Heart Failure (CRHF) Therapy Development and Clinical Research, Medtronic, Mounds View, MN (R.H., J.D.L., D.R.L., S.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Willey","sequence":"additional","affiliation":[{"name":"Cardiac Rhythm &amp; Heart Failure (CRHF) Therapy Development and Clinical Research, Medtronic, Mounds View, MN (R.H., J.D.L., D.R.L., S.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaldoun G.","family":"Tarakji","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine and Heart and Vascular Institute, Cleveland Clinic, OH (B.L.W., K.G.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the WRAP-IT Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2011.03150.x"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.15420\/aer.2015.27.2"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.04.033"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.009081"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2017.09.001"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/pace.12518"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euu147"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/pace.13300"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.116.003929"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/jce.12684"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1901111"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2016.06.010"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90019-1"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-200503000-00003"},{"key":"e_1_3_5_16_2","unstructured":"CPT copyright 2018. 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