Helix screw leadless pacemakers resulted in a longer paced QRS duration (180±26 ms) compared to flexible tine leadless pacemakers (151±22 ms) and transvenous pacemakers (156±25 ms, p<0.0001).
Observational (n=267)
Does the type of leadless pacemaker affect the placement site and paced QRS duration compared to transvenous pacemakers in patients undergoing pacemaker implantation?
The type of leadless pacemaker influences the right ventricular placement site, with helix screw types resulting in significantly longer paced QRS durations compared to flexible tine types and transvenous pacemakers.
Absolute Event Rate: 180% vs 151%
p-value: p=<0.0001
Abstract Backgrounds Two types of leadless pacemakers (LPs) (flexible tine and helix screw type) with different placement methods are available. The effect of those LPs on the paced QRS duration remains unclear. Objective To investigate the placement site and the paced QRS duration by type of LPs. Methods 267 patients who underwent pacemaker implantation (PMI) were evaluated (57 males, 82±8 years, 164 transvenous pacemakers, 70 flexible tine LPs, and 33 helix screw LPs). Clinical data and blood samples were obtained before PMI. The paced QRS duration was measured during VVI pacing. The right ventricle where PMs were placed was divided into three areas (outflow, middle, and bottom) on RAO 30° view. Results Indications for pacing were sick sinus syndrome 66, atrioventricular block 91, atrial fibrillation with bradycardia 7 in patients with transvenous PM, 28/24/18 with flexible tine LPs, and 13/18/2 with helix screw LPs. PMs and PM leads were placed in 61 patients in the middle area (50 with flexible tine LPs, 11 with helix screw LPs, and 0 with transvenous PM), 205 patients in the bottom area, and the flexible tine LPs were implanted in the outflow area in one patient. The middle-area rate of PM placement position was higher in patients with flexible tine LPs than helix screw LPs and transvenous PM (50 out of 70; 71%, 11 of 33; 33%, 0 of 28; 0%, p0.0001). The paced QRS duration of the middle-area implantation did not differ from that of the bottom-area implantation among all patients (153±25 vs 160±26ms, p=0.1058). There was no difference in the paced QRS duration between LPs and transvenous PM (161±27 vs 156±25ms, p=0.3454). The paced QRS duration of the bottom-area implantation with LPs was longer than that of the middle-area implantation with LPs and transvenous PM (176±27ms, 153±24, 156±25ms, p=0.0074). The paced QRS duration was longer in patients with helix screw LPs than flexible tine LPs and transvenous PM (180±26ms, 151±22, 156±25ms, p0.0001). Conclusion The placement site varies depending on the type of leadless pacemaker, which might affect the paced QRS duration.
Sugitani et al. (Sat,) conducted a observational in Pacemaker implantation (n=267). Leadless pacemakers (flexible tine and helix screw) vs. Transvenous pacemakers was evaluated on Paced QRS duration (p=<0.0001). Helix screw leadless pacemakers resulted in a longer paced QRS duration (180±26 ms) compared to flexible tine leadless pacemakers (151±22 ms) and transvenous pacemakers (156±25 ms, p<0.0001).
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