Key result
Leadless Micra pacing achieves equivalent safety and 100% success in patients aged ≥85 years.
Why the study?
Elderly patients undergoing cardiac pacemaker implantation are at high risk of complications related to transvenous leads and pockets, and the feasibility and outcomes of leadless pacemakers in this population require investigation.
Observational (n=145)
No
Rates of cardiac pacemaker implantation rise with age, and, meanwhile, elderly patient may be at great risk of complications, as pneumothorax, lead perforation, or pocket dehiscence. The use of leadless pacemaker could overcome peri- and post-procedural complications related to the presence of transvenous leads and pocket. The study aims to investigate feasibility and outcomes of Micra Transcatheter Pacing System (M-TPS) implantation in elderly, which represents a challenge for conventional cardiac pacing. Between May 2014 and July 2019, 109 patients (88 males, mean age 77.71±9.68 years) underwent M-TPS implantation at our Center, targeting a non-apical site of delivery when feasible. Study population was divided into two groups according to age (group 1 <79 years vs group 2 group 2 ≥80 years). The outcome evaluation included electrical performance at hospital discharge, and during follow-up. In 46/109 cases (34 males, 73.91%) M-TPS was implanted in patients older than 80 years. There were no statistically significant differences between groups for demographics characteristics, except for age. The procedure was performed via the right femoral access in 102/109 cases and was successful in all cases, with no device-related events. No differences were observed between groups in procedure duration, single device delivery, electrical performance at implant and at 12 month F-U. MTP-S implant is an effective and safe procedure in elderly patients, with similar electrical performance and outcome compared with younger patients at mid-term follow-up.
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Barletta et al. (2020) conducted an observational in Bradycardia requiring VVI pacing (n=145). Micra Transcatheter Pacing System (Micra TPS) vs. Patients aged <85 years receiving the same device was evaluated on Procedural success. The Micra Transcatheter Pacing System was successfully implanted in 100% of patients with no device-related events, demonstrating equivalent safety and electrical performance in patients aged ≥85 years compared to those <85 years (p>0.05).
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