In patients with Micra VR pacemakers, a history of atrial fibrillation (HR 5.77; 95% CI 1.64-20.3) and reduced LVEF ≤50% (HR 7.04; 95% CI 1.89-26.2) independently predicted heart failure hospitalization.
Cohort (n=94)
What are the incidence and predictors of heart failure hospitalization in patients undergoing de novo Micra VR leadless pacemaker implantation?
In patients receiving a Micra VR leadless pacemaker, a history of atrial fibrillation and reduced LVEF (≤50%) are strong independent predictors of subsequent heart failure hospitalization.
Hazard Ratio: 5.77 (95% CI 1.64–20.3)
p-value: p=0.006
Abstract Background Micra VR TPS, the first leadless pacemaker, offers a high effectiveness and lower complication rate than conventional transvenous pacemakers. It is especially suitable for patients with activities of daily living(ADL) decline. However, the risk of heart failure hospitalization after Micra VR implantation remains largely unexplored. Purpose We investigated the incidence and predictors of heart failure hospitalization in patients who underwent de novo Micra VR implantations. Methods and Results Ninety-four consecutive patients who underwent de novo Micra VR implantation (mean age 84.6±6.9 years, 45 males) were enrolled. During the mean follow-up period of 640±392 days, 17 (18.1%) patients were hospitalized due to heart failure post-implantations. Heart failure hospitalization was associated with a history of atrial fibrillation(AF) and reduced left ventricular ejection fraction (LVEF≤50%). Multivariate analysis revealed that a history of AF (hazard ratio HR, 5.77; 95% confidence interval CI, 1.64–20.3; P = 0.006) and reduced LVEF(LVEF≤50%) (HR, 7.04; 95% CI, 1.89–26.2; P = 0.004) were independent risk factors for heart failure hospitalization. Conclusions The presence of AF history and reduced LVEF were predictors of heart failure hospitalization in patients with Micra VR. Micra VR might become a reasonable device choice in patients who have normal LVEF and no history of AF especially in those with ADL decline.Graphical abstract
Matsumura et al. (2025) conducted a cohort in Patients undergoing de novo Micra VR implantation (n=94). History of atrial fibrillation and reduced LVEF (≤50%) vs. No history of atrial fibrillation and normal LVEF was evaluated on Heart failure hospitalization (HR 5.77, 95% CI 1.64-20.3, p=0.006). In patients with Micra VR pacemakers, a history of atrial fibrillation (HR 5.77; 95% CI 1.64-20.3) and reduced LVEF ≤50% (HR 7.04; 95% CI 1.89-26.2) independently predicted heart failure hospitalization.