Associazione Nazionale Medici Cardiologi Ospedalieri



Times, are they a-changing? Implantation and Follow-Up Experience with Leadless Pacemakers (MICRA) at Pisa University Hospital

Barletta Valentina Pisa(Pisa) – Azienda Ospedaliero Universitaria Pisana | Parlato Alessandro Pisa(Pisa) – Azienda Ospedaliero Universitaria Pisana | Tamborrino Pietro Paolo Pisa(Pisa) – Azienda Ospedaliero Universitaria Pisana

Background: Leadless pacing represents a pivotal advancement in cardiac stimulation. Eliminating traditional pacing leads, leadless devices offer reduced complications, a bailout strategy for many previously challenging cases and streamlined procedures.

Purpose: This retrospective study aimed to compare, starting from December 1st 2023, newer implants (within the 3 years preceding Dec 1st 2023) and older implants (>3 years before) in a single-center experience with M-TPS (Micra Transcatheter Pacing System) in terms of safety and efficacy, at baseline and in a short-term follow-up (6 months).

Methods: A comprehensive analysis was conducted on 195 patients who underwent leadless pacemaker implantation at our Center, and that were followed-up for a minimum of 6 months. The cohort was stratified into two groups: recent (n=73) and less recent implants (n=122). Procedural variables, patient demographics, and clinical outcomes were documented. Post-implantation follow-up data include pacing threshold, fluoroscopy time, and other relevant variables.

Results: Comparison between the two groups revealed significant differences fluoroscopy time. Newer implants demonstrated a reduced fluoroscopy time [8 (IQR 5-12) vs 10 minutes (IQR 7-14)], suggesting potential advancements in technique. No significant differences were observed in other procedural or electrical parameters.

Discussion: The comparison between older and newer leadless pacemaker implants reveals reassuring constancy in most parameters, suggesting the reliability of the M-TPS. The reduced fluoroscopy time aligns with the evolving proficiency of implanters and improved procedural efficiency. The dependable consistency observed across various parameters strengthens the confidence in the M-TPS, reinforcing its status as a reliable and effective solution for pacing.

Conclusion: The implantation and follow-up experience at our center elucidates very few differences between newer and older implants. This nuanced analysis contributes to the ongoing evolution of leadless pacemaker technology, which heralds a transformative era in cardiac care. With several years of implementation, accumulated follow-up data unveils valuable insights into its sustained effectiveness, guiding clinicians in optimizing patient outcomes and solidifying leadless pacing as a breakthrough in the realm of cardiac rhythm management.