Key result
Same-day discharge after MICRA leadless pacemaker implantation had similar rates of major complications compared to overnight observation (0.0% vs. 3.5%, p=1.00).
Why the study?
Although same-day discharge after transvenous pacemaker implantation is safe and feasible, whether this strategy is feasible and safe following Medtronic MICRA leadless pacemaker implantation was unknown.
Does same-day discharge increase major complications in patients undergoing MICRA leadless pacemaker implantation?
Cohort (n=167)
No
Does same-day discharge increase major complications in patients undergoing MICRA leadless pacemaker implantation?
Absolute Event Rate: 0% vs 3.5%
p-value: p=1.00
Same-day discharge after MICRA leadless pacemaker implantation appears safe and feasible in appropriately selected patients, with no increase in major complications at 45 days.
Same-day MICRA discharge appears feasible in selected patients; leaves open need for prospective confirmation before practice change.
BACKGROUND: Data suggests that same day discharge after implantation of trans-venous pacemakers is safe and feasible. We sought to determine whether same day discharge was feasible and safe following implantation of Medtronic MICRA leadless pacemakers. METHODS: We retrospectively identified all patients undergoing MICRA placement at our institution between April 2014 to August 2018 (n=167). Patients were stratified into two groups: those discharged on the same day as their procedure (SD, n=25), and those observed for at least one night in the hospital (HD, n=142). The primary endpoint included a composite of major complications including: access site complications, new pericardial effusion, device dislodgement, and need for device revision up to approximately 45 days of follow up. RESULTS: SD and HD had similar age (75±13 vs. 75±13 years, p=0.923), prevalence of male sex (49 vs. 44%, p=0.669), and frequency of high-grade heart block as an indication for pacing (38 vs. 32%, p=0.596). There were more Caucasians in the SD group (72 vs. 66%, p=0.038). The rate of the composite endpoint was statistically non-significantly higher in the HD group (3.5% vs. 0.0%, p=1.00). The rates of each individual components comprising the composite endpoint were similar between groups. CONCLUSIONS: Our data suggest that in appropriately selected patients, same day discharge can occur safely following Micra leadless pacemaker implantation.
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Kiani et al. (2019) conducted a cohort in Patients undergoing MICRA leadless pacemaker implantation (n=167). Same-day discharge vs. Observed for at least one night in the hospital was evaluated on Composite of major complications including access site complications, new pericardial effusion, device dislodgement, and need for device revision (p=1.00). Same-day discharge after MICRA leadless pacemaker implantation had similar rates of major complications compared to overnight observation (0.0% vs. 3.5%, p=1.00).
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