Related Experiment Video
Updated: May 28, 2026
06:14
Translational Rabbit Model of Chronic Cardiac Pacing
Published on: January 6, 2023
Long-Term Outcomes of Leadless Pacemaker vs. Transvenous Pacemaker in End-Stage Renal Disease.
Siddharth Agarwal1, Harsh P Patel1, Shivaraj Patil1
1Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Journal of Cardiovascular Electrophysiology
|May 26, 2026
Summary
Leadless pacemakers (LPMs) show fewer device re-interventions in end-stage renal disease (ESRD) patients on dialysis compared to transvenous pacemakers (TPMs). Long-term outcomes were similar, suggesting LPMs may be a safer alternative for this high-risk group.
Area of Science:
- Cardiology
- Nephrology
- Medical Devices
Background:
- Patients with end-stage renal disease (ESRD) on dialysis face higher risks of pacemaker complications.
- Limited vascular access and infection susceptibility exacerbate these risks.
- Conventional transvenous pacemakers (TPMs) may pose greater challenges in this population.
Purpose of the Study:
- To compare the long-term safety and efficacy of leadless pacemakers (LPMs) versus TPMs in ESRD patients on dialysis.
- To assess risks of device re-intervention, complications, and mortality.
Main Methods:
- Retrospective cohort study using TriNetX Research Network (May 2016 - Dec 2020).
- Included adults (≥18 years) with ESRD on dialysis receiving LPM or TPM.
- Propensity score matching (1:1) for demographics and comorbidities.
- Outcomes evaluated up to 5 years: hospitalization, re-intervention, complications, mortality.
Main Results:
- After matching 901 patients per group, LPMs showed significantly lower device re-intervention rates (4.1% vs. 9.3%; HR 0.44; p<0.01).
- No significant differences observed in all-cause hospitalization, heart failure hospitalization, or all-cause mortality.
- Comparable rates of device-related complications, infection-related hospitalizations, and pacemaker-induced cardiomyopathy between LPM and TPM groups.
Conclusions:
- In ESRD patients on dialysis, leadless pacemakers (LPMs) are associated with fewer device re-interventions compared to transvenous pacemakers (TPMs).
- LPMs demonstrate comparable long-term clinical outcomes, including mortality and major complications, in this high-risk cohort.
More Related Videos
06:04Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
12:45Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
Published on: December 11, 2017
Related Concept Videos
01:29Cardiomyopathy V: Interprofessional Care
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
01:28Kidney Transplant I: Introduction
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
01:24Hemodialysis II: Procedure and Complications
DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
01:30Continuous Renal Replacement Therapy
Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
01:26Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy
Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in critically...
01:16Kidney Transplant III: Nursing Management
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...