Outcomes of leadless pacemaker implantation following transvenous lead extraction in high-volume referral centers: Real-world data from a large international registry
Articolo
Data di Pubblicazione:
2022
Citazione:
Outcomes of leadless pacemaker implantation following transvenous lead extraction in high-volume referral centers: Real-world data from a large international registry / G. Mitacchione, M. Schiavone, A. Gasperetti, G. Arabia, A. Breitenstein, M. Cerini, P. Palmisano, E. Montemerlo, M. Ziacchi, S. Gulletta, F. Salghetti, G. Russo, C. Monaco, P. Mazzone, D. Hofer, F. Tundo, G. Rovaris, A.D. Russo, M. Biffi, E.C.L. Pisanò, G.B. Chierchia, P. Della Bella, C. de Asmundis, A.M. Saguner, C. Tondo, G.B. Forleo, A. Curnis. - In: HEART RHYTHM. - ISSN 1547-5271. - (2022 Dec 06), pp. 1-10. [10.1016/j.hrthm.2022.12.002]
Abstract:
Background: Limited data on the real-world safety and efficacy of leadless pacemakers (LPMs) post-transvenous lead extraction (TLE) are available. Objective: The purpose of this study was to assess the long-term safety and effectiveness of LPMs following TLE in comparison with LPMs de novo implantation. Methods: Consecutive patients who underwent LPM implantation in 12 European centers joining the International LEAdless PacemakEr Registry were enrolled. The primary end point was the comparison of LPM-related complication rate at implantation and during follow-up (FU) between groups. Differences in electrical performance were deemed secondary outcomes. Results: Of the 1179 patients enrolled, 15.6% underwent a previous TLE. During a median FU of 33 (interquartile range 24-47) months, LPM-related major complications and all-cause mortality did not differ between groups (TLE group: 1.6% and 5.4% vs de novo group: 2.2% and 7.8%; P = .785 and P = .288, respectively). Pacing threshold (PT) was higher in the TLE group at implantation and during FU, with very high PT (>2 V@0.24 ms) patients being more represented than in the de novo implantation group (5.4% vs 1.6 %; P = .004). When the LPM was deployed at a different right ventricular (RV) location than the one where the previous transvenous RV lead was extracted, a lower proportion of high PT (>1-2 V@0.24 ms) patients at implantation, 1-month FU, and 12-month FU (5.9% vs 18.2%, P = .012; 3.4% vs 12.9%, P = .026; and 4.3% vs 14.5%, P = .037, respectively) was found. Conclusion: LPMs showed a satisfactory safety and efficacy profile after TLE. Better electrical parameters were obtained when LPMs were implanted at a different RV location than the one where the previous transvenous RV lead was extracted.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
CIED; Device-related complications; Leadless pacemaker; Micra; Transvenous lead extraction
Elenco autori:
G. Mitacchione, M. Schiavone, A. Gasperetti, G. Arabia, A. Breitenstein, M. Cerini, P. Palmisano, E. Montemerlo, M. Ziacchi, S. Gulletta, F. Salghetti, G. Russo, C. Monaco, P. Mazzone, D. Hofer, F. Tundo, G. Rovaris, A.D. Russo, M. Biffi, E.C.L. Pisanò, G.B. Chierchia, P. Della Bella, C. de Asmundis, A.M. Saguner, C. Tondo, G.B. Forleo, A. Curnis
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