PADIT-score and device infection in pacemaker or defibrillator surgery 99 the discrepancy in infection rates with other studies. Considering the single-center design and low number of events, the results of our study should be interpreted with caution, and larger prospective studies are warranted. 5. Conclusions When using strict preventive measures, the risk of CIED infection can be relatively low. The PADIT-score had a good discriminative value in our study population for identifying patients at high risk for CIED infections. In our real-world all-comers cohort, a PADIT-score of ≥7 identified a high-risk population in which an antibacterial envelope may be cost-effective considering a standard-of-care infection rate of >1%. However, randomized trials are needed to evaluate whether the strategy of using an antibacterial envelope only in patients with a high PADIT score is beneficial and costeffective. Funding None. Ethics declarations The Medical Ethics Committee reviewed the study (MEC-2020–0299), and this retrospective single-center study was not subjected to the Dutch Medical Research Involving Human Subjects Act. The study was carried out according to the ethical principles for medical research involving human subjects established by Declaration of Helsinki, protecting the privacy of all the participants and the confidentiality of their personal information. Conflicts of interest SCY is a consultant for Boston Scientific and has received institutional research grants and speaker fees from Medtronic, Boston Scientific and Biotronik. TST has received institutional research grants from Abbott, Biosense Webster, Acutus Medical, Stereotaxis and Catheter Precision. TST had received consultancy and speaker fees from Ablacon, Acutus Medical and Stereotaxis until 2022. The other authors report no conflicts of interest related to the subject of this manuscript. 6
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