What question did this study set out to answer?

To compare the safety, efficacy, and intermediate- to long-term clinical outcomes of leadless pacemakers against conventional transvenous pacemakers in adults requiring permanent cardiac pacing.

January 18, 2026Journal of High School ScienceOpen Access

Safety and long-term outcomes of leadless vs. conventional lead-based pacemakers

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Key result

Leadless pacemakers may reduce device-related complications vs. conventional pacemakers in adults with bradycardia.

Why the study?

Leadless pacemakers emerged to reduce lead- and pocket-related complications of conventional transvenous pacemakers, but intermediate- to long-term comparative outcomes required systematic evaluation.

Do leadless pacemakers reduce device-related complications and re-interventions compared to conventional transvenous pacemakers in adults with symptomatic bradycardia?

Key Points

To compare the safety, efficacy, and intermediate- to long-term clinical outcomes of leadless pacemakers against conventional transvenous pacemakers in adults requiring permanent cardiac pacing.
Searched PubMed from 2020 through 2025 for observational and cohort studies evaluating leadless versus transvenous pacemakers in adults (≥18 years) with bradycardia.
Identified four eligible studies assessed using the Newcastle-Ottawa Scale, with two high-quality studies reporting compatible hazard ratios pooled using a random-effects model.
Quantitative meta-analysis revealed a numerical trend toward fewer device-related complications with leadless pacemakers, though the pooled difference did not achieve statistical significance.
Individual studies demonstrated that leadless pacemakers, particularly the Micra™ AV system, were linked to fewer re-interventions and lower rates of lead dislodgement, infection, and device-related pain.
Higher all-cause mortality observed in certain leadless pacemaker cohorts was largely driven by higher baseline comorbidity rather than device-related harm (heterogeneity I² = 29.8%).

Structured PICO

Do leadless pacemakers reduce device-related complications and re-interventions compared to conventional transvenous pacemakers in adults with symptomatic bradycardia?

Population

Adults (≥18 years) with symptomatic bradycardia requiring permanent pacemaker implantation. The systematic review included 4 studies (2 observational cohorts in the quantitative meta-analysis).

Intervention

Leadless pacemakers (LPs), predominantly the Micra™ AV system.

Comparator

Conventional dual-chamber transvenous pacemakers (TVPs).

Outcome

Safety (device-related complications), re-intervention rates, and all-cause mortality.safety

Leadless pacemakers show a trend toward fewer device-related complications compared to transvenous pacemakers, though higher baseline comorbidities in recipients currently confound mortality outcomes, highlighting the need for randomized trials.

Limitations

Current evidence base is derived predominantly from short-term observational studies
Residual confounding since leadless pacemakers are preferentially implanted in older, more comorbid, and frailer patients
Limited insight into long-term results such as AV synchrony durability and retrieval feasibility
Lack of cost-effectiveness analyses in lower- and middle-income populations

Discussion

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Implication

May support Micra AV preference in high-risk bradycardia patients; leaves open confirmation by RCTs.

Cite This Study

Tanya Chakraborty (2026) studied this question. Leadless pacemakers, particularly the Micra™ AV system, may reduce device-related complications compared to conventional pacemakers in adults with bradycardia.

synapsesocial.com/papers/696c789ceb60fb80d1396ccb https://doi.org/10.64336/001c.155396

Topics

Left Bundle Branch Area Pacing

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Safety and long-term outcomes of leadless vs. conventional lead-based pacemakers

Key Points

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Topics

Safety and long-term outcomes of leadless vs. conventional lead-based pacemakers

Key Points

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider