Arrhythmias & electrophysiologyCohort study
Leadless pacemaker, right ventricular pacing burden, and heart failure
- registry-based observational study
Authors' conclusion
Baseline %RVP thresholds of 20% and 40% may help identify patients with LPs who are at an increased risk of HF. However, the HF hazard increased progressively with an increasing %RVP. Given the lack of established upgrade pathways for current LP systems, careful patient selection and follow-up may be particularly important for patients expected to have a high pacing burden.
Study context
- Population
- Patients who underwent leadless pacemaker implantation from 2015 to 2025, without a prior heart failure (HF) diagnosispatients with single-chamber leadless pacemakers (LPs)
- Participants
- 3,167 patients
- Exposure
- Patients with higher baseline %RVP at 20% and 40% cutoffs compared with those with lower %RVP
- Outcome
- First recorded HF diagnosis
- Follow-up
- Over 2.4 years
Main finding
As reported in the abstract
patients had the primary outcome
577 (18%)
Observational data: associations, not effects.
Further findings
HF risk by baseline %RVP at 20% and 40% cutoffs
- Higher baseline %RVP had increased risks of HF compared with lower %RVP
- P < 0.05
HF hazard with time-varying %RVP
- per 10% increase, hazard ratio
- 1.035 [1.013-1.059]
- multivariable Cox model
Baseline characteristics and pacing burden
- mean age
- 76 ± 13 years
- women
- 45%
- median baseline %RVP
- 71% (8%-98%)
- median absolute %RVP difference over 2.4 years
- 5.5% (0.7%-21.6%)
Original publication
Leadless pacemaker, right ventricular pacing burden, and heart failure. Heart Rhythm. Published 4 September 2026. doi:10.1016/j.hrthm.2026.09.001
Summarised from the published abstract; every number is checked against it