AI Article Synopsis
- The study aimed to assess the safety and effectiveness of implanting a leadless pacemaker via the jugular vein as an alternative to the traditional femoral vein method, particularly for patients where femoral access isn't viable.
- Researchers analyzed data from 100 patients implanted with the Micra™ leadless pacemaker through the jugular vein, finding that this method resulted in shorter procedure and fluoroscopy times compared to the femoral approach, with similar electrical performance of the devices.
- Complications were notably fewer with the jugular approach (only 2 reported) compared to 16 complications in the femoral method, suggesting that the jugular route is a safer option for leadless pacemaker implantation.*
Article Abstract
Aims: Leadless pacemaker therapy was introduced to overcome lead- and pocket-related complications in conventional transvenous pacemaker systems. Implantation via the femoral vein, however, may not always be feasible. The aim of this study was to evaluate leadless pacemaker implantation using a jugular vein approach and compare it to the standard implantation via the femoral vein.
Methods And Results: The records of the first consecutive 100 patients undergoing Micra™ leadless pacemaker implantation via the right internal jugular vein from two centres were included in this study. Peri-procedural safety and efficacy of the jugular approach were compared to the first 100 patients using a femoral implantation approach at the University Hospital Zurich. One hundred patients underwent successful implantation of a leadless pacemaker via the internal jugular vein (mean age, 81.18 ± 8.29, 60% males). Mean procedure time was 35.63 ± 10.29 min with a mean fluoroscopy time of 4.66 ± 5.16 min. The device was positioned at the inferior septum in 25 patients, at the high septum in 24 patients, and mid-septum in 51 patients. The mean pacing threshold was 0.56 ± 0.35 V at 0.24 ms pulse width with a sensed amplitude of 10.0 ± 4.4 mV. At follow-up, electrical parameters remained stable in all patients. Compared with femoral implantation, patients undergoing the jugular approach were of similar age and had similar comorbidities. Mean procedure (48.9 ± 21.0 min) and fluoroscopy times (7.7 ± 7.8 min, both P < 0.01) were shorter compared to the femoral approach. Electrical parameters were similar between the two approaches. There were only two complications during jugular veinous implantations (1 pericardial effusion and 1 dislocation), compared to 16 complications using the femoral approach (1 pericardial effusion, 2 femoral artery injuries, and 13 major groin haematomas).
Conclusion: The jugular approach may represent a safe and efficient alternative to femoral implantation of the Micra leadless pacemaker.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11304476 | PMC |
| http://dx.doi.org/10.1093/europace/euae199 | DOI Listing |
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