Arrhythmias & electrophysiology
Leadless pacemakers in patients with different stages of chronic kidney disease: Real-world data from the updated i-LEAPER registry
Authors' conclusion
In a real-world setting, patients with advanced CKD who underwent LPM implantation were underrepresented. Although all-cause mortality was higher in end-stage CKD, periprocedural complications and LPM performance were overall comparable between NKF and different stages of CKD, except for higher values of pacing threshold in patients with CKD up to first-month follow-up.
Study context
- Population
- Consecutive patients with leadless pacemaker implantation in the i-LEAPER registry, stratified by chronic kidney disease (CKD) stage
- Participants
- 1,748 patients
- Exposure
- Leadless pacemaker (LPM) outcomes by CKD stage: NKF vs CKD G3a/G3b vs CKD G4/G5
- Outcome
- LPM-related major complication rate at implantation and during follow-up
- Follow-up
- Median 39 months (IQR 18-59 months)
Methodological detailsmulticentre, international, consecutive patients
- Multicentre
- International
- Consecutive patients
Main finding
As reported in the abstract
LPM-related major complications · median 39 months
P = 0.418
Observational data: associations, not effects.
Secondary outcomes
| Outcome | NKF | G3a/G3b | G4/G5 | Adjusted HR (95% CI) | P value | |
|---|---|---|---|---|---|---|
| All-cause mortalityG4/G5vs NKF | 9.8% | — not stated in the abstract | 19.5% | 1.9 (1.25–2.89) | P = 0.003 | |
| 0.20.5125Adjusted hazard ratio (log scale) |
— not stated in the abstract
Pacing threshold @ 0.24 ms · 1 month — NKF vs G3a/G3b vs G4/G5
P < 0.001
Pacing threshold @ 0.24 ms · 1 month
- LPM electrical performance otherwise comparable between groups
Original publication
Leadless pacemakers in patients with different stages of chronic kidney disease: Real-world data from the updated i-LEAPER registry. Heart Rhythm. Published 17 July 2024. doi:10.
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