Key result
Mid septum deployment of the MICRA transcatheter pacing system was associated with a narrower paced QRS duration (139.33 ms) compared to apical implantation (166.60 ms).
Why the study?
The authors sought to assess the safety and impact on paced QRS of implanting the MICRA transcatheter pacing system at various RV sites in an Indian population.
Does the implantation site of a leadless pacemaker affect paced QRS duration and safety in an Indian population?
Observational (n=35)
No
Does the implantation site of a leadless pacemaker affect paced QRS duration and safety in an Indian population?
Absolute Event Rate: 139.33% vs 166.6%
Mid-septal deployment of leadless pacemakers is associated with a narrower paced QRS duration compared to apical deployment, with stable pacing parameters and LVEF.
May support mid-septal MICRA positioning; hypothesis-generating for outcomes in non-randomized data.
BACKGROUND: In this study we report our experience in implanting MICRA TPS (transcatheter pacing system) at various RV sites; observing its safety, and impact on paced QRS in Indian population. MATERIAL & METHODS: 35 patients with MICRA TPS deployed from March 2017 to December 2019 at Army Hospital Research and Referral, New Delhi, at RVOT, apical septum and mid septum of RV were enrolled in the study. These patents were followed up and impact of implantation site, procedure related complications, change in pacing parameters, left ventricular ejection fraction and duration of paced QRS were monitored. RESULTS: Sick sinus syndrome was the commonest indication of pacing in this study (51.5%), followed by high degree AV block (34.2%). Mean follow up of 1.4 years showed no change in left ventricular ejection fraction, electrical parameters or change in pacing thresholds after implantation. Mean pQRS was broadest (166.60 ms) in apically implanted MICRA TPS and narrowest in mid septum group 139.33 ms. Among 35 cases, in our study one patient developed pericardial effusion, and other had intermittent diaphragmatic pacing. CONCLUSION: Among these three implantation sites mid septum deployment is associated with narrowest paced QRS in Indian population.
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Sharma et al. (2020) conducted an observational in Bradyarrhythmia requiring pacing (Sick sinus syndrome, high degree AV block) (n=35). MICRA TPS implantation at mid septum vs. MICRA TPS implantation at apical septum was evaluated on Paced QRS duration. Mid septum deployment of the MICRA transcatheter pacing system was associated with a narrower paced QRS duration (139.33 ms) compared to apical implantation (166.60 ms).
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