Intracardiac leadless versus transvenous permanent pacemaker implantation: Impact on clinical outcomes and healthcare utilization

Anton Mararenko, Ndausung Udongwo, Viraaj Pannu, Brett Miller, Abbas Alshami, Firas Ajam, Mihir Odak, Kameron Tavakolian, Steven Douedi, Arman Mushtaq, Arif Asif, Brett Sealove, Jesus Almendral, Eran Zacks, Joseph Heaton

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Transvenous permanent pacemakers are used frequently to treat cardiac rhythm disorders. Recently, intracardiac leadless pacemakers offer potential treatment using an alternative insertion procedure due to their novel design. Literature comparing outcomes between the two devices is scarce. We aim to assess the impact of intracardiac leadless pacemakers on readmissions and hospitalization trends. Methods: We analyzed the National Readmissions Database from 2016 to 2019, seeking patients admitted for sick sinus syndrome, second-degree-, or third-degree atrioventricular block who received either a transvenous permanent pacemaker or an intracardiac leadless pacemaker. Patients were stratified by device type and assessed for 30-day readmissions, inpatient mortality, and healthcare utilization. Descriptive statistics, Cox proportional hazards, and multivariate regressions were used to compare the groups. Results: Between 2016 and 2019, 21,782 patients met the inclusion criteria. The mean age was 81.07 years, and 45.52 % were female. No statistical difference was noted for 30-day readmissions (HR 1.14, 95 % CI 0.92–1.41, p = 0.225) and inpatient mortality (HR 1.36, 95 % CI 0.71–2.62, p = 0.352) between the transvenous and intracardiac groups. Multivariate linear regression revealed that length of stay was 0.54 (95 % CI 0.26–0.83, p < 0.001) days longer for the intracardiac group. Conclusion: Hospitalization outcomes associated with intracardiac leadless pacemakers are comparable to traditional transvenous permanent pacemakers. Patients may benefit from using this new device without incurring additional resource utilization. Further studies are needed to compare long-term outcomes between transvenous and intracardiac pacemakers.

Original languageEnglish
Pages (from-to)378-387
Number of pages10
JournalJournal of Cardiology
Volume82
Issue number5
DOIs
StatePublished - Nov 2023
Externally publishedYes

Keywords

  • Healthcare utilization
  • Intracardiac leadless pacemaker
  • Readmission
  • Transvenous permanent pacemaker

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