Key result
Leadless pacemakers may be a better option than temporary pacemakers for urgent treatment, with procedure durations ranging from 36 to 180 minutes and shorter hospital stays.
Why the study?
Leadless pacemakers have become a prevalent alternative to traditional transvenous pacemakers, but consolidated data on leadless pacemaker implantation in emergencies were lacking.
Does leadless pacemaker implantation improve procedural outcomes and reduce hospital stay compared to temporary pacemakers in emergency settings?
Systematic Review (n=1,276)
Does leadless pacemaker implantation improve procedural outcomes and reduce hospital stay compared to temporary pacemakers in emergency settings?
Leadless pacemakers may be a viable and potentially superior alternative to temporary pacemakers for urgent treatment of underlying arrhythmias, offering shorter hospital stays.
LPMs may be preferable to temporary pacemakers in urgent settings; supports randomized trials before practice change.
BACKGROUND: During the last decade, leadless pacemakers (LPMs) have turned into a prevalent alternative to traditional transvenous (TV) pacemakers; however, there is no consolidated data on LPM implantation in emergencies. METHODS: Digital databases were searched for this review and four relevant studies, including 1276 patients were included in this review with procedure duration, fluoroscopic time, major complications, and mortality as primary outcomes and pacing threshold, impedance, sensing of LPM, and hospital stay as secondary outcomes. RESULTS: Gonzales et al. and Marschall et al. showed the duration of the procedure to be 180 ± 45 versus 324.6 ± 92 and 39.9 ± 8.7 versus 54.9 ± 9.8, respectively. Zhang et al. demonstrated the duration of the procedure and fluoroscopy time to be 36 ± 13.4 and 11.1 ± 3.1, respectively. Similarly, Schiavone et al. exhibited intermediate times of implantation at 60 (45-80) versus 50 (40-65) and fluoroscopic times at 6.5 (5-9.7) versus 5.1 (3.1-9). Hospital stay was more with a temp-perm pacemaker as compared to LPM and pacing parameters were not significantly different in all the studies. CONCLUSION: For underlying arrhythmias, whenever appropriate, our review shows that LPMs may be a better option than temporary pacemakers, even as an urgent treatment.
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Noor et al. (2023) conducted a systematic review in Arrhythmias requiring pacemaker in emergencies (n=1,276). Leadless pacemakers vs. Temporary pacemakers was evaluated on Procedure duration, fluoroscopic time, major complications, and mortality. Leadless pacemakers may be a better option than temporary pacemakers for urgent treatment, with procedure durations ranging from 36 to 180 minutes and shorter hospital stays.
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