Transcatheter Leadless Pacing in Children: A PACES Collaborative Study in the Real-World Setting

Area of Science:

• Pediatric Cardiology
• Electrophysiology
• Medical Device Technology

Background:

• Transcatheter Leadless Pacemakers (TLP) offer a less invasive alternative for adult pacing.
• Pediatric patients and those with congenital heart disease may benefit from TLP, avoiding repeated surgeries.
• Clinical trial data for TLP in children are limited, creating uncertainty regarding their use.

Purpose of the Study:

• To assess the clinical indications for TLP implantation in pediatric patients.
• To evaluate the procedural characteristics and electrical performance of TLP in children.
• To determine the safety and outcomes of TLP in the pediatric population.

Main Methods:

• Retrospective analysis of data from the Pediatric and Congenital Electrophysiology Society TLP registry.
• Inclusion of patients ≤21 years old who underwent Micra TLP implantation with ≥1 week follow-up.
• Data collected from 15 participating centers.

Main Results:

• Successful TLP implantation in 98% of 63 pediatric patients (mean age 15 years).
• 20% of patients had congenital heart disease; 8 patients were ≤8 years old and ≤30 kg.
• High implantation success via femoral (87%) and internal jugular (12.6%) venous approaches, with stable electrical parameters and infrequent major complications (16%).

Conclusions:

• TLP implantation via femoral and internal jugular veins is highly successful in pediatric patients.
• Micra TLP demonstrated stable electrical parameters and a low rate of major complications in this cohort.
• Further long-term prospective studies are required to validate these initial findings.