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Acute and long‐term outcomes of simultaneous atrioventricular node ablation and leadless pacemaker implantation
Author(s) -
MartínezSande José Luis,
RodríguezMañero Moisés,
GarcíaSeara Javier,
Lago Ramón,
GonzálezMelchor Laila,
Kreidieh Bahij,
Iacopino Saverio,
Regibus Valentina,
Greef Yves,
Bruno Schwagten,
Curnis Antonio,
Sieira Juan,
Chierchia Gian Battista,
Brugada Pedro,
GonzálezJuanatey José Ramón,
Asmundis Carlo
Publication year - 2018
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.13496
Subject(s) - medicine , ablation , observational study , surgery , population , cardiology , environmental health
Aims Leadless pacemaker (LDP) allows implantation using a femoral approach. This access could be utilized for conventional atrioventricular nodal ablation (AVNA). It could facilitate unifying the two procedural components. Data regarding its feasibility and long‐term outcomes remain lacking. We aim to evaluate the feasibility and long‐term outcomes of sequential LDP and AVNA. Methods Prospective, observational multicenter study including consecutive patients with indication for single‐chamber pacemaker placement. In those with additional indication for AVNA, ablation was performed immediately after the LPD through the same sheath. Results A total of 137 patients were included. Mean age was 77.9 ± 10.5 years; 74 (54%) were men. Immediately following LDP implantation, 27 patients (19.7%) underwent concurrent AVNA. There were six (5.5%) complications in patients referred for LDP procedures and three (11%) in those who underwent a combined approach. None of these complications were solely attributable to the added AVNA component. No mechanical dislodgement, electrical damage to any device, or electromagnetic interference ever took place. During a mean follow‐up period of 123 ± 48 days, three patients (3.6%) died of noncardiovascular causes. The remaining population stayed alive without significant arrhythmias. There were no relevant differences with regard to sensing and pacing thresholds between patients in the two groups. Conclusions AVNA can safely be performed immediately following LDP. A combined approach obviates the need for additional vascular access and optimizes feasibility and comfort for patients and healthcare providers. It offers an acceptable safety and efficacy profile, both acutely and upon intermediate‐term follow‐up.