Key result
Leadless pacemakers accounted for only 9% of all implants, and were more frequently chosen for patients with atrial fibrillation, multiple comorbidities, or a high anticipated risk of infection.
Why the study?
The study was conducted to evaluate the proportion of leadless pacemaker implants and identify the factors influencing the choice of leadless versus transvenous pacemakers across tertiary centres in Europe with routine leadless pacemaker availability.
What factors influence the choice of leadless versus transvenous pacemakers in European tertiary centres?
Cross-Sectional (n=798)
Yes
What factors influence the choice of leadless versus transvenous pacemakers in European tertiary centres?
Leadless pacemakers constitute a small minority (9%) of pacemaker implants in European tertiary centers and are preferentially used in patients with atrial fibrillation, higher comorbidities, and high anticipated infection risk.
Answers are grounded in this paper and cite their sources.
Supports targeted leadless pacemaker use in high-infection-risk patients; leaves open comparative effectiveness versus transvenous devices.
To study the proportion of leadless pacemaker (LL-PM) implants and the factors influencing the choice of LL-PM vs. transvenous pacemaker (TV-PM) across tertiary centres in Europe with routine availability of the LL-PM. A European Heart Rhythm Association (EHRA) prospective snapshot survey using electronically distributed questionnaire sent to participating centres. Participating tertiary cardiac pacing centres prospectively included consecutive patients implanted between November 2018 and January 2019. Questions covered standards of care and policies used for patient management, focusing particularly on the reasons for choosing LL-PM vs. TV-PM. Overall, 21 centres from four countries (France, Netherlands, Spain, and Italy) participated, with eventual data from 798 patients (n = 472, 59% male). With 69 implants, LL-PM represented only 9% of all implants and 36% of the single-chamber pacing group; double-chamber transvenous pacemakers were implanted in 528 patients and biventricular (cardiac resynchronization pacemaker) in 79. The two major reasons reported in favour of LL-PM implantation were an anticipated high risk of infection or low rate of ventricular pacing. Compared to TV-PM, LL-PM patients were more often male (74% vs. 54%, P = 0.009), with greater proportion of valvular heart disease (45% vs. 35%, P = 0.01) and atrial fibrillation (AF; 65% vs. 23%, P < 0.0001), with significantly more comorbidities (≥ one comorbidity, 66% vs. 52%, P = 0.02). This contemporary multicentre European survey shows that LL-PM constitutes a small proportion of all PM implants. Patients implanted with LL-PM were more likely to have AF and a high anticipated risk of infection.
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Bovéda et al. (2020) conducted a cross-sectional in Pacemaker implantation (n=798). Leadless pacemaker (LL-PM) vs. Transvenous pacemaker (TV-PM) was evaluated on Proportion of leadless pacemaker implants. Leadless pacemakers accounted for only 9% of all implants, and were more frequently chosen for patients with atrial fibrillation, multiple comorbidities, or a high anticipated risk of infection.
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