Leadless pacemaker with transcatheter aortic valve implantation: A single-center experience

Pacing Clin Electrophysiol. 2023 Jul;46(7):615-622. doi: 10.1111/pace.14702. Epub 2023 Apr 29.

Abstract

Background: The safety and efficacy of leadless pacemakers (LP) in transcatheter aortic valve implant (TAVI) patients is not well known due to paucity of data. Herein, we compared outcomes between leadless pacemakers to traditional dual chamber pacemakers (DCP) following TAVI.

Methods: A single-center retrospective study was conducted, including a total of 27 patients with LP and 33 patients with DCP after TAVI between November 2013 and May 2021. We compared baseline demographics, pacemaker indications, complication rates, percent pacing, and ejection fractions.

Results: Leading indications for pacemaker implant were complete heart block (74% LP, 73% DCP) and high degree atrioventricular block (26% LP, 21% DCP). Twenty-two (82%) LP patients had devices implanted in the right ventricular septal-apex. Three (9%) DCP patients required rehospitalization for pocket related complications. Zero pacemaker-related mortality was observed in both groups. Frequency of ventricular pacing and ejection fraction was similar between LP and DCP groups.

Conclusion: From this single-center retrospective study, LP implant was feasible following TAVI and was found to have comparable performance to DCPs. LPs may be a reasonable alternative in TAVI patients where single ventricular pacing is indicated. Larger studies are required to validate these findings.

Keywords: a ortic valve implantation; aortic valve implantation; ejection fraction; leadless pacemaker; pacemaker dependency; permanent pacemaker; transcatheter aortic valve implantation.

MeSH terms

  • Aortic Valve / surgery
  • Aortic Valve Stenosis* / surgery
  • Atrioventricular Block*
  • Cardiac Pacing, Artificial / adverse effects
  • Humans
  • Pacemaker, Artificial* / adverse effects
  • Retrospective Studies
  • Transcatheter Aortic Valve Replacement* / adverse effects
  • Treatment Outcome