Leadless pacing in the elderly: never too old for something new.

Area of Science:

• Cardiology
• Medical Devices
• Geriatric Medicine

Background:

• Cardiac pacemaker implantation rates increase with age.
• Elderly patients face higher risks of complications with traditional pacemakers, including pneumothorax and lead perforation.
• Leadless pacemakers may mitigate procedural complications associated with transvenous leads and device pockets.

Purpose of the Study:

• To assess the feasibility and outcomes of Micra Transcatheter Pacing System (M-TPS) implantation in elderly patients.
• To evaluate M-TPS performance in patients aged 80 years and older compared to younger elderly patients.
• To determine if M-TPS is a viable alternative for cardiac pacing in the geriatric population.

Main Methods:

• A retrospective study of 109 patients undergoing M-TPS implantation between May 2014 and July 2019.
• Patients were stratified into two groups: <79 years and ≥80 years.
• Outcomes assessed included procedural success, electrical performance at discharge and 12-month follow-up, and device-related events.

Main Results:

• M-TPS implantation was successful in all 109 patients, with no device-related events.
• 46% of patients were aged 80 years or older.
• No significant differences were observed in procedure duration, device delivery, or electrical performance between the age groups at implant and 12-month follow-up.

Conclusions:

• Micra Transcatheter Pacing System (M-TPS) implantation is a safe and effective procedure for elderly patients, including those 80 years and older.
• The M-TPS demonstrates comparable mid-term electrical performance and outcomes in elderly patients versus younger counterparts.
• Leadless pacing offers a promising solution for cardiac pacing challenges in the geriatric population.