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Is day-case surgical procedure safe for MICRA leadless pacemaker implantation?
Lin-Thiri Toon1,2, Mohammed ElRefai3, Mohamed Abouelasaad3
1Cardiac Rhythm Management Research Department, University Hospital Southampton, Southampton, SO16 6YD, UK. lin.toon@uhs.nhs.uk.
Background:
MICRA implantation is not commonly done as a day-case procedure. Elective leadless pacemakers are implanted routinely in our centre.
Objective:
To assess whether the day-case MICRA procedure is safe.
Methods:
We retrospectively collected data from all patients undergoing elective MICRA implantation at our centre between May 2014 and Nov 2022 (n = 81). Two patient groups were stratified: those planned to be discharged on the same day (SD, n = 52) and those planned to be observed overnight after the procedure (ON, n = 29). Patient demographics, size of the sheath used, type of MICRA device, and rate of complications were recorded. In patients with successful implants (n = 80), device function at discharge and first routine follow-up were evaluated.
Results:
There were 58% males in the SD group and 45% in the ON group. Median age was 49 years in the SD and 67 years in the ON. Among patients who were planned as a day case, 8 patients had to stay in the hospital but for < 48 h: 2 due to minor groin bleeding, 1 due to patient's request despite fit to discharge, 4 due to the procedure carried out later in the day, and 1 for observation due to procedural complexity. MICRA implantation was successful in 80 patients. The rate of the major complications was 2% in the SD group and 7% in the ON group (p = 0.223), and none of the co-morbidities assessed showed an association with any complications. Device parameters at the follow-up were available in 76 patients. The rate of patients with low and stable PCT at follow-up was also 98% in the SD group and 96% in the ON group.
Conclusions:
Day case MICRA procedure can be performed safely in an appropriately selected patient population.
