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Leadless Pacemaker vs. Transvenous Pacemaker in End Stage Kidney Disease: Insights from the Nationwide Readmission
Sajog Kansakar1, Azka Naeem1, Norbert Moskovits2
1Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY 11219, USA.
Journal of Clinical Medicine
|January 11, 2025
Summary
Leadless pacemakers in end-stage renal disease (ESRD) patients showed higher short-term complications and costs compared to transvenous pacemakers. However, in-hospital mortality and 30-day readmissions were similar between the two groups.
Area of Science:
- Cardiology
- Nephrology
- Medical Devices
Background:
- Leadless pacemakers are an alternative pacing strategy.
- Limited data exist for leadless pacemaker use in end-stage renal disease (ESRD) patients.
Purpose of the Study:
- To compare outcomes of leadless versus transvenous pacemaker implantation in adult ESRD patients.
- To evaluate in-hospital mortality, 30-day readmissions, complications, and healthcare resource utilization.
Main Methods:
- Retrospective analysis of the Nationwide Readmission Database (2016-2021).
- Inclusion of adult patients with ESRD undergoing transvenous or leadless pacemaker implantation.
- Comparison of in-hospital mortality, 30-day readmission rates, complication rates, and healthcare costs.
Main Results:
- Leadless pacemaker implantation in ESRD patients was associated with higher in-hospital complications, including blood transfusion, vascular, and cardiac complications.
- No significant differences were observed in in-hospital mortality and 30-day readmission rates between leadless and transvenous pacemaker groups.
- Leadless pacemaker implantation resulted in a longer length of stay and higher hospitalization charges.
Conclusions:
- Despite potential long-term benefits, leadless pacemakers in ESRD patients are linked to increased short-term in-hospital complications.
- In-hospital mortality and 30-day readmissions were comparable between leadless and transvenous pacemaker implantation in this population.
- Further research is needed to optimize leadless pacemaker use in ESRD patients, considering the observed short-term risks and increased costs.
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