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Published on: February 28, 2012
First short-term European experiences with dual-chamber leadless pacing: Early safety and electrical outcomes
Maciej Dyrbuś1, Jakub Kawecki2, Anna Kurek3
13rd Department of Cardiology, School of Medical Sciences in Zabrze, Silesian Center for Heart Diseases, Medical University of Silesia, Katowice, Poland. mdyrbus@op.pl.
Background:
Leadless pacemakers (LPMs) eliminate the need for transvenous leads and subcutaneouspockets. However, comparative real-world data between dual-chamber LPMs and conventionaltransvenous pacemakers are lacking to date.
Aims:
Our aim was to present the first single-center experience with dual-chamber LPM and tocompare early electrical performance, safety, and 90-day clinical outcomes with contemporarydual-chamber transvenous systems.
Methods:
This investigator-initiated registry included consecutive patients undergoing dual-chamber pacemaker implantation: 178 dual-chamber transvenous pacemakers (2023-2024) and 27 dual-chamber LPMs (2024-2025). Leadless implantations were performed as two stages due toreimbursement regulations. Baseline characteristics, procedural parameters, electrical performanceat implantation and 90 days, and complication rates were analyzed.
Results:
Patients receiving LPMs had a higher prevalence of prior device infection (22.2% vs. 1.1%;P <0.001), chronic dialysis (22.2% vs. 1.1%; P <0.001), and malignancy (18.5% vs. 3.4%; P = 0.007). Proceduralsuccess was achieved in all LPM cases. Despite staged implantation, the 90-day complicationrate was low and comparable between patient groups (7.4% vs. 4.5%; P = 0.62). Electrical parametersimproved over time in the LPM group, with stable low pacing thresholds at 90 days. However, theestimated battery longevity was shorter in the LPM cohort.
Conclusions:
In this real-world preliminary comparison, dual-chamber leadless pacing demonstratedpromising short-term safety outcomes despite implantation in a clinically complex population,traditionally considered to be at elevated risk for transvenous systems. These findings suggestconsideration of dual-chamber leadless pacing in selected high-risk patients.
