Does leadless pacemaker implantation reduce the rate of pacing-induced cardiomyopathy compared to transvenous pacemaker implantation in patients requiring pacing?
Leadless pacemakers and transvenous pacemakers have comparable rates of pacing-induced cardiomyopathy, with prolonged paced QRS and lower baseline LVEF identified as risk factors.
Background: Pacing-induced cardiomyopathy (PICM) has been reported among patients with transvenous pacemakers (TVP). Recent reports have suggested that the incidence may be lower among patients with leadless pacemakers (LP). We performed a multicenter retrospective study to better define these rates and to identify any potential risk factors. Objective: To determine the rates of PICM between LP and TVP and risk factors for development of PICM in each cohort. Methods: Patients implanted with either a Micra transcatheter LP or TVP between November 2015 and January 2022 were identified from medical records at 3 large medical centers. PICM was defined as a decrease in left ventricular ejection fraction (LVEF) from pre-implant in patients with a baseline LVEF of ≥50% with a resulting post-implant LVEF ≤40% who received at least 20% ventricular pacing. Logistic regression was used to determine univariate and multivariable predictors of PICM. Results: .001). Conclusion: PICM rates are comparable between LP and TVP implantation. Prolonged paced QRS is a predictor for development of PICM and higher pre-implantation LVEF is protective.
Lee et al. (Tue,) studied this question.