Arrhythmias & electrophysiology
Outcomes of leadless pacemaker implantation following transvenous lead extraction in high-volume referral centers: Real-world data from a large international registry
Authors' conclusion
LPMs showed a satisfactory safety and efficacy profile after TLE. Better electrical parameters were obtained when LPMs were implanted at a different RV location than the one where the previous transvenous RV lead was extracted.
Study context
- Population
- Consecutive patients undergoing leadless pacemaker implantation, International LEAdless PacemakEr Registry15.6% previous TLE
- Participants
- 1,179 patients
- Exposure
- LPM implantation after TLE vs de novo LPM implantation
- Outcome
- LPM-related complication rate at implantation and during FU
- Follow-up
- Median FU 33 months (IQR 24-47)
Methodological details12 European centres, consecutive patients
- 12 European centres
- Consecutive patients
Main finding
As reported in the abstract
LPM-related major complications · median FU 33 months
P = 0.785
Observational data: associations, not effects.
Secondary outcomes
All-cause mortality · median FU 33 months
P = 0.288
Very high pacing threshold (>2 V@0.24 ms)
P = 0.004
- High pacing threshold (>1-2 V@0.24 ms), LPM at different right ventricular (RV) location vs same location as extracted lead (TLE subgroup) · implantation, 1-month follow-up (FU), 12-month FU · implantation: 5.9% vs 18.2%
- P = 0.012
- High pacing threshold (>1-2 V@0.24 ms), LPM at different RV location vs same location as extracted lead (TLE subgroup) · implantation, 1-month FU, 12-month FU · 1-month FU: 3.4% vs 12.9%
- P = 0.026
- High pacing threshold (>1-2 V@0.24 ms), LPM at different RV location vs same location as extracted lead (TLE subgroup) · implantation, 1-month FU, 12-month FU · 12-month FU: 4.3% vs 14.5%
- P = 0.037
Very high pacing threshold (>2 V@0.24 ms)
- Pacing threshold higher in TLE group at implantation and during FU
Safety
LPM-related major complications · median FU 33 months
P = 0.785
Original publication
Outcomes of leadless pacemaker implantation following transvenous lead extraction in high-volume referral centers: Real-world data from a large international registry. Heart Rhythm. Published 7 December 2022. doi:10.
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