Leadless pacemaker versus transvenous single-chamber pacemaker therapy: A propensity score-matched analysis

Fleur V.Y. Tjong, Reinoud E. Knops, Erik O. Udo, Tom F. Brouwer, Srinivas R. Dukkipati, Jacob S. Koruth, Jan Petru, Lucie Sediva, Norbert M. van Hemel, Petr Neuzil, Vivek Y. Reddy

Research output: Contribution to journalArticlepeer-review

41 Scopus citations

Abstract

Background: The recent introduction of leadless pacemakers (PMs) was aimed to eliminate transvenous lead- and pocket-related complications. While the initial results with the leadless PMs seem promising, the nonrandomized nature, limited implant experience of operators, and short follow-up period of these studies preclude a simple comparison to transvenous PMs. Objectives: The objective of this study was to provide a balanced comparison of leadless and transvenous single-chamber PM therapies through a propensity score-matched analysis. Methods: Leadless patients from 3 experienced leadless implant centers were propensity score-matched to VVI-R patients from a contemporary prospective multicenter transvenous PM registry. The primary outcome was device-related complications that required invasive intervention during mid-term follow-up. Separate analyses including and excluding PM advisory–related complications were performed. Results: A total of 635 patients were match-eligible (leadless: n = 254; transvenous: n = 381), of whom 440 patients (median age 78 years; interquartile range 70–84 years; 61% men) were successfully matched (leadless: n = 220 vs transvenous: n = 220). The complication rate at 800 days of follow-up was 0.9% (95% confidence interval [CI] 0%–2.2%) in the leadless group vs 4.7% (95% CI 1.8%–7.6%) in the transvenous group when excluding PM advisory–related complications (P =.02). When including these PM advisory–related complications, the complication rate at 800 days increased to 10.9% (95% CI 4.8%–16.5%) in the leadless group vs 4.7% (95% CI 1.8%–7.6%) in the transvenous group (P =.063). Conclusion: This study reveals favorable complication rates for leadless compared to transvenous single-chamber pacing therapy at mid-term follow-up in a propensity score-matched cohort. When including PM advisory–related complications, this advantage is no longer observed.

Original languageEnglish
Pages (from-to)1387-1393
Number of pages7
JournalHeart Rhythm
Volume15
Issue number9
DOIs
StatePublished - Sep 2018

Keywords

  • Arrhythmia
  • Leadless pacemaker
  • Leadless pacing
  • Pacemakers
  • Pacing

Fingerprint

Dive into the research topics of 'Leadless pacemaker versus transvenous single-chamber pacemaker therapy: A propensity score-matched analysis'. Together they form a unique fingerprint.

Cite this