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Related Concept Videos

Dysrhythmias IV: Characteristics of Bradyarrhythmias01:18

Dysrhythmias IV: Characteristics of Bradyarrhythmias

Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...

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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Leadless Pacemaker in Bradyarrhythmia After Transcatheter Aortic Valve Replacement: A Meta-Analysis.

Patavee Pajareya1, Watsapon Chuanchai1, Khamik Laohasurayotin1

  • 1From the Division of Cardiovascular Medicine, Center of Excellence in Arrhythmia Research, Cardiac Center, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand.

Cardiology in Review
|June 18, 2026
PubMed
Summary

Leadless pacemakers (LPM) show a significantly lower complication rate for bradyarrhythmia after transcatheter aortic valve replacement (TAVR) compared to transvenous pacemakers (TPM). LPM offers a safer alternative with comparable efficacy and feasibility.

Keywords:
bradyarrhythmialeadless pacemakermeta-analysistranscatheter aortic valve replacement

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Area of Science:

  • Cardiovascular Medicine
  • Medical Devices
  • Interventional Cardiology

Background:

  • Transvenous pacemakers (TPM) carry infection risks, particularly in patients needing bradyarrhythmia management post-transcatheter aortic valve replacement (TAVR).
  • The safety and efficacy of leadless pacemakers (LPM) in the post-TAVR bradyarrhythmia population remain largely unexamined.

Purpose of the Study:

  • To systematically evaluate the safety and feasibility of leadless pacemakers (LPM) versus transvenous pacemakers (TPM) for bradyarrhythmia management following transcatheter aortic valve replacement (TAVR).
  • To compare complication rates, mortality, heart failure hospitalizations, and procedural metrics between LPM and TPM in this patient cohort.

Main Methods:

  • A systematic literature search was conducted from inception to November 2025, including studies of adult patients receiving pacemakers after TAVR.
  • Primary endpoints included overall and device-related complications; secondary endpoints encompassed mortality, heart failure hospitalizations, procedure time, fluoroscopy time, and length of stay.
  • Meta-analysis was performed on data from 11 studies involving 11,750 patients (1243 LPM, 10,507 TPM).

Main Results:

  • The leadless pacemaker (LPM) group demonstrated significantly lower device-related complication rates (aHR 0.35) and no device-related mortality compared to the transvenous pacemaker (TPM) group.
  • All-cause mortality and heart failure hospitalization rates were comparable between LPM and TPM groups.
  • Procedural feasibility, including procedure time, fluoroscopy time, and length of stay, was similar between LPM and TPM.

Conclusions:

  • Leadless pacemakers (LPM) represent a safer first-line pacing strategy for bradyarrhythmia post-transcatheter aortic valve replacement (TAVR).
  • LPM offers comparable efficacy and feasibility to traditional transvenous pacemakers (TPM) with a reduced risk of device-related complications.