First European experience with a leadless atrial pacemaker
Background: Leadless pacemakers (LPs) can reduce long-term complications compared with conventional devices. However, previous studies have primarily focused on single chamber right ventricular LPs. Objective: This study aimed to evaluate the implantation, safety, and device performance characterist...
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| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-08-01
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| Series: | Heart Rhythm O2 |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666501825001618 |
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| Summary: | Background: Leadless pacemakers (LPs) can reduce long-term complications compared with conventional devices. However, previous studies have primarily focused on single chamber right ventricular LPs. Objective: This study aimed to evaluate the implantation, safety, and device performance characteristics in a first real-world European use of an active fixation atrial LP for either dual chamber or single chamber pacing. Methods: For this prospective, single-center, single-operator analysis, we included consecutive patients undergoing implantation of an active fixation atrial LP either as a standalone therapy or as part of a dual chamber LP system. Results: Of the 45 included patients, 22 (48.9%) underwent de novo dual chamber, 9 (20%) an upgrade from ventricular single chamber to dual chamber, and 14 (31.1%) an atrial single chamber LP implantation. All implantations were successful and without the need for device repositioning. The median procedure time was 35 minutes (interquartile range 30–40), and complications occurred in 2 patients (4.4%) who developed pericardial effusions. Sensing, impedance, and stimulation thresholds of the atrial and ventricular device remained stable or improved over a median follow-up of 21 days. Median implant-to-implant throughput was 88% for atrial-to-ventricular and 87% for ventricular-to-atrial. The estimated median battery life of the atrial device was significantly higher in single chamber vs dual chamber settings (11.9 years vs 5.8 years, P < .001). Conclusion: Our first real-world European experience demonstrates that leadless atrial pacemaker implantation can be performed efficiently and safely, with satisfactory device measurements during the early follow-up period. |
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| ISSN: | 2666-5018 |