Leadless pacemaker implantation in elderly Asian patients was safe and feasible, with major complications comparable to transvenous single-chamber pacemakers (5.6% vs 11.9%, p=0.14).
Cohort (n=149)
Yes
Does leadless pacemaker implantation improve procedural safety and feasibility compared to transvenous single-chamber pacemakers in elderly small-framed Asian patients?
Leadless pacemaker implantation is safe, feasible, and associated with shorter procedure times and fewer prolonged hospitalizations compared to transvenous systems in frail, small-framed Asian octogenarians.
Absolute Event Rate: 5.6% vs 11.9%
p-value: p=0.14
Abstract Background Leadless pacemaker (LPM) therapy eliminates pocket- and lead-related complications of transvenous systems, however its large delivery sheath may raise safety concerns in small-framed elderly Asian patients. Data in this population remain scarce. Aim To assess the procedural safety, feasibility, and short-term outcomes of LPM implantation in elderly Asian patients, and to compare them with transvenous single-chamber pacemakers (TV-PM). Methods We retrospectively analyzed 149 consecutive patients (90 LPM, 59 TV-PM) aged ≥80 years who underwent pacemaker implantation at three Japanese centers between 2010 and 2021. Primary endpoints were procedural safety and feasibility. Secondary endpoints included all-cause mortality, heart-failure hospitalization, and device-related complications within 2 years Results Median age was 90 83–94 vs 84 83–95 years; mean height 148.8 ± 9.7 vs 155.8 ± 12.2 cm, confirming a smaller body habitus in this Asian cohort. LVEF was similar (60.0% vs 64.5%, p = 0.16), but renal dysfunction was more common in TV-SPM (76.3% vs 46.7%, p 0.001). All implantations were successful. Despite frailty and smaller anatomy, LPM procedures were shorter (55.7 ± 25.8 vs 78.5 ± 15.8 min, p = 0.008) and required fewer prolonged hospitalizations (48 h beyond plan: 48.9% vs 64.4%, p = 0.05). Major complications were infrequent and comparable (5.6% vs 11.9%, p = 0.14). Conclusion LPM implantation is safe and feasible even in frail, small-framed Asian octogenarians. These findings suggest that LPM can overcome anatomical and procedural limitations of transvenous systems, supporting broader adoption in aging Asian populations.
Asami et al. (Mon,) conducted a cohort in Pacemaker indication in elderly small-framed patients (n=149). Leadless pacemaker (LPM) vs. Transvenous single-chamber pacemakers (TV-PM) was evaluated on Procedural safety and feasibility (major complications) (p=0.14). Leadless pacemaker implantation in elderly Asian patients was safe and feasible, with major complications comparable to transvenous single-chamber pacemakers (5.6% vs 11.9%, p=0.14).
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