Leadless Permanent Pacing: A Single Centre Australian Experience - 15/10/19
, Adam C. Lee, MBBS a, b, Caleb Mengel, MBBS a, b, Simon Townsend, BSc a, John Betts, BSc a, Nicole Bovey, BSc a, Daniel Wright, BSc a, Oscar Davison, BSc a, Haris M. Haqqani, MBBS, PhD a, bRésumé |
Background |
To describe the performance and clinical outcomes of consecutive patients having a leadless pacemaker (LP) implanted at a single institution.
Methods |
Clinical data and device parameters were prospectively collected on all patients undergoing LP implantation from November 2015 to April 2018.
Results |
A total of 79 patients (52 male), median age of 78 years, was included. Leadless pacemaker implantation was successful in 76 patients (96%). Implantation failed in two patients due to excessive venous tortuosity and due to inadequate sensing in another. Seventy-three (73) patients (96%) had chronic atrial fibrillation and all had a Class I or II indication for pacing. Procedure time was 29minutes (IQR 21–43) and fluoroscopy time was 8minutes (IQR 5–13). The median R wave at implant was 11.2mV (IQR 6.9–15.0). The median capture threshold at 0.24ms was 0.5V (IQR 0.4–0.9) and impedance was 754Ω (IQR 680–880). Intraprocedural acute dislodgement occurred in one patient following cutting of the tether but successful snaring and reimplantation was performed. During a median follow-up of 355days (range 9–905), overall electrical performance has been excellent. No patients have been readmitted for device revision or complications. Five (5) patients (7%) died during follow-up from unrelated causes.
Conclusions |
Leadless pacemakers can be implanted safely and effectively in the majority of patients. Device electrical performance was excellent over a median follow-up of 12 months.
Le texte complet de cet article est disponible en PDF.Keywords : Bradycardia, Heart block, Leadless pacemaker, Atrial fibrillation
Plan
Vol 28 - N° 11
P. 1677-1682 - novembre 2019 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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