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Leadless pacemaker implantation: A feasible and reasonable option in transcatheter heart valve replacement patients
Author(s) -
Moore Sarah K. L.,
Chau Katherine H.,
Chaudhary Salma,
Rubin Geoffrey,
Bayne Joseph,
Avula Uma Mahesh R.,
Wang Daniel Y.,
Sorbera Carmine,
Dizon Jose,
Biviano Angelo,
Waase Marc,
Iyer Vivek,
George Isaac,
Kodali Susheel K.,
Nazif Tamim M.,
Garan Hasan,
Wan Elaine Y.
Publication year - 2019
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.13648
Subject(s) - medicine , cardiology , atrial fibrillation , retrospective cohort study , regurgitation (circulation) , tricuspid valve , transthoracic echocardiogram , endocarditis , surgery
Background Leadless pacemakers (LPMs) have been shown to have lower postoperative complications than traditional permanent pacemakers but there have been no studies on the outcomes of LPMs in patients with transcatheter heart valve replacements (THVRs). This study determined outcomes of LPMs compared to transvenous single‐chamber pacemakers (SCPs) post‐THVR. Methods This is a retrospective single‐center study including 10 patients who received LPMs post‐THVR between February 2017 and August 2018 and a comparison group of 23 patients who received SCP post‐THVR between July 2008 and August 2018. LPM or SCP was implanted at the discretion of electrophysiologists for atrial fibrillation with slow ventricular response or sinus node dysfunction with need for single‐chamber pacing only. Results LPMs were associated with decreased tricuspid regurgitation ( P = 0.04) and decreased blood loss during implantation (7.5 ± 2.5 cc for LPMs vs 16.8 ± 3.2 cc for SCPs, P = 0.03). Five LPM patients had devices positioned in the right ventricular septum as seen on transthoracic echocardiogram. Frequency of ventricular pacing was similar between LPM and SCP groups. In the LPM group, one case was complicated by a pseudoaneurysm and one death was due to noncardiac causes. There was one pneumothorax and one pocket infection in the SCP group. Conclusions In this small retrospective study, LPMs were feasible post‐THVR and found to perform as well as SCPs, had less intraprocedural blood loss, and were associated with less tricuspid regurgitation. Further, larger studies are required to follow longer‐term outcomes and complications.