Leadless pacemaker implant with concomitant atrioventricular node ablation: Experience with the Micra transcatheter...

Area of Science:

• Cardiology
• Electrophysiology
• Medical Devices

Background:

• The combination of atrioventricular node ablation (AVNA) and leadless pacemaker implantation is not extensively studied.
• This study investigates the outcomes of patients undergoing Micra leadless pacemaker implantation with concomitant AVNA.

Purpose of the Study:

• To evaluate the feasibility and clinical outcomes of performing AVNA concurrently with Micra leadless pacemaker implantation.
• To compare outcomes between patients who underwent AVNA with Micra implant versus those who received Micra implant alone.

Main Methods:

• A cohort of 192 patients who underwent AVNA at the time of Micra implant were analyzed.
• These patients were compared to 2616 patients who received Micra implant without AVNA.
• Outcomes included acute and follow-up results, electrical performance, and complication rates.

Main Results:

• Implantation success rate was high (99.5%).
• Pacing thresholds remained stable throughout the follow-up period (mean 20.4 months).
• Major complications within 30 days were more frequent in the AVNA group (7.3% vs. 2.0%), with a higher overall risk at 36 months (HR: 3.81).

Conclusions:

• Concomitant AVNA and leadless pacemaker implantation is technically feasible.
• While pacing parameters are stable, the procedure is associated with an increased risk of major complications.
• Patient comorbidities significantly influence the risk profile in this combined procedure.