A single tapered Coons dilator significantly reduced device deployment time (15.1 vs 23.5 min, p<0.0005) and total time compared to sequential serial dilation for Micra pacemaker implantation.
Cohort (n=84)
Does a single tapered Coons dilator reduce device deployment time and total time compared to sequential serial dilatation in patients undergoing Micra leadless pacemaker implantation?
Using a single tapered Coons dilator for Micra leadless pacemaker implantation significantly reduces deployment time, total procedure time, and cost compared to sequential serial dilatation.
Tasa de eventos absoluta: 15.1% vs 23.5%
valor p: p=<0.0005
OBJECTIVES: Comparison of outcomes, device deployment time (DT), and total time (TT) using a single tapered Coons dilator versus sequential serial dilation for implantation of the Micra leadless pacemaker. BACKGROUND: Micra leadless pacemaker placement requires a 23 French Micra introducer sheath (MIS) for percutaneous delivery. We sought to evaluate outcomes with use of a single tapered Coons dilator (CD) versus sequential serial dilatation (SD) method to facilitate insertion of the Micra introducer sheath. METHODS: 35 patients were included in the SD arm and 49 in the CD arm. DT and TT were recorded in minutes and cost in dollars. Analysis was performed using independent t-test between two groups and one-way ANOVA to evaluate inter-operator variability in the CD arm. RESULTS: Both DT and TT were significantly lower for the CD arm (15.1 ± 5.1 vs 23.5 ± 9.3, p < 0.0005 and 29.9 ± 14 vs 39.3 ± 13.5 min, p = 0.000374; respectively). The cost was also significantly lower using a CD versus SD. There was no inter-operator variability in the CD arm between 6 operators (p = 0.177 for DT and p = 0.304 for TT). No complications occurred in the SD arm. There were 3 vascular access site complications in the CD arm, all of which occurred early in the operator's experience. CONCLUSION: Coons dilator is an efficient and cost-effective method for vascular dilatation to facilitate Micra leadless pacemaker insertion. Rate of complications is low and expected to improve with greater experience.
Mohammed et al. (Wed,) conducted a cohort in Micra leadless pacemaker implantation (n=84). Single tapered Coons dilator vs. Sequential serial dilatation was evaluated on Device deployment time (minutes) (p=<0.0005). A single tapered Coons dilator significantly reduced device deployment time (15.1 vs 23.5 min, p<0.0005) and total time compared to sequential serial dilation for Micra pacemaker implantation.