AI Article Synopsis
- Leadless pacemaker (LP) implantation is becoming a viable alternative for patients with prior conventional pacing systems (CPS), with a study analyzing its safety and effectiveness in 257 patients from two Swiss centers.
- Out of the patients studied, 24 had previous CPS, and a significant number (83%) required lead extraction due to various issues, while LP implantation showed low complication rates overall.
- Results indicated that LP implantation was effective and safe even in patients with prior CPS, as no infections or complications occurred after the procedures, contributing to positive outcomes in this population.
Article Abstract
Background: Leadless pacing has been established as an alternative approach to transvenous devices for selected patients. Often, leadless pacemaker (LP) implantation is a de novo procedure, but in an increasing number of patients, an LP is used after previous implantation of a conventional pacing system (CPS).
Methods: A retrospective analysis was conducted of the efficacy and safety of LP implantation in the context of a previously implanted CPS, from 2 large Swiss centres.
Results: A total of 257 consecutive patients undergoing LP implantation were included. They were divided into 2 groups: group 1 consisted of 233 patients who did not have a previous CPS, and group 2 consisted of 24 patients with an in situ CPS. In group 2, a total of 20 patients (83%) required transvenous lead extraction due to infection, malfunction, or other reasons. In 3 patients with device-related infection, lead extraction and LP implantation was performed as a single procedure, whereas in the remaining 11 cases, a time window occurred between the 2 procedures (median: 11.5 days; range: 2-186 days). Electrical device parameters at implantation and during follow-up did not differ between the 2 groups (mean: 12.5 ± 9.3 months). Eight major periprocedural complications (3.1%) were encountered (4 pericardial effusions, 3 instances of femoral bleeding, and 1 instance of intra-abdominal bleeding) in the entire cohort within a 30-day period. No complications occurred in the group with a previous device. No infections were registered, even when complete extraction of an infected CPS was performed prior to LP implantation.
Conclusions: Implantation of an LP in patients with a prior CPS (with or without extraction of the previous system) was effective and safe in our population of patients.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11065736 | PMC |
| http://dx.doi.org/10.1016/j.cjco.2023.12.008 | DOI Listing |
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