Micra leadless pacemaker implant time was significantly associated with a prominent septal component of the septomarginal trabeculation (P<0.001) and operator experience (P<0.001).
Observational (n=126)
No
What are the operator, patient, and anatomical determinants of implant procedure time for the Micra leadless pacemaker?
Leadless pacemaker implantation time is significantly influenced by operator experience and specific right ventricular anatomical features, such as a prominent septal component of the septomarginal trabeculation.
p-value: p=<0.001
BACKGROUND: The Micra Transcatheter Pacing System is implanted directly in the right ventricle (RV) through the femoral vein using a steerable transcatheter delivery system. The present study was done to identify determinants of difficult leadless pacemaker implant procedures including operator, patient, and RV anatomical characteristics. METHODS: All patients who underwent a Micra implant from July 2015 to December 2018 at our center were analyzed. From an RV angiogram acquired during implantation, RV geometry including systolic and diastolic volumes and ejection fraction was characterized. The presence of septomarginal trabeculation was noted. RESULTS: One hundred twenty-six patients (mean age: 79 ± 11 years old, mostly male: 77%) were enrolled. Mean Micra RV implant procedure time was 24 ± 23 min, with 1.7 ± 1.3 deployments of the device. No significant change in implant procedure time was observed after the first 30 implants. Eleven patients had a prominent septal component of the septomarginal trabeculation in the RV. Univariate analysis showed that the procedure time was positively correlated with the presence of a prominent septal component of the septomarginal trabeculation (P < .001) or an episode of heart failure (P = .02) and negatively correlated with the number of procedures performed by the operator (P < .001). After multivariable analysis, only the presence of a prominent septal component of the septomarginal trabeculation (P < .001) and the number of procedures performed by the operator (P < .001) were associated with the implant procedure time. CONCLUSIONS: In our experience, implant procedure time of a Micra leadless pacemaker depended on the presence of a prominent septal component of the septomarginal trabeculation and operator experience.
Garweg et al. (Sun,) conducted a observational in Leadless pacemaker implantation (n=126). Micra Transcatheter Pacing System implantation was evaluated on Implant procedure time (p=<0.001). Micra leadless pacemaker implant time was significantly associated with a prominent septal component of the septomarginal trabeculation (P<0.001) and operator experience (P<0.001).