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Leadless pacing system: real-word comparison between two system devices
Session:
Comunicações Orais - Sessão 16 - Pacing cardíaco
Speaker:
Pedro Carmo
Congress:
CPC 2024
Topic:
C. Arrhythmias and Device Therapy
Theme:
09. Device Therapy
Subtheme:
09.6 Device Therapy - Other
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Pedro Lopes do Carmo; Joana Brito; Catarina Oliveira; Rita Amador; Beatriz Garcia; Francisco Costa; Margarida Martins; Pedro Galvão Santos; Sérgio Fartoso; João de Sousa; Pedro Adragão; Pedro Marques
Abstract
<p style="text-align:center"> </p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="color:#222222">Introduction: </span></span></strong><span style="font-size:12.0pt"><span style="color:#222222">Leadless pacing was developed as an alternative to transvenous pacing systems aiming to reduce pocket and lead related complications. Micra transcatheter pacing systems (Medtronic) have been implanted since 2016 and real-world results present high rates of successful and safe implantations. Nevertheless, important limitations persist, halting their generalization. The most concerning is battery depletion and the need for replacement. Since September 2023 an alternative device from Abbott Medical (Aveir) became available in two centers in Portugal. Test results have shown longer longevity and possibility of device extraction.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="color:#222222">Purpose: </span></span></strong><span style="font-size:12.0pt"><span style="color:#222222">To describe the pivotal results of the first Aveir implantation in two centers in Portugal and to compare with the corresponding Micra implantations.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="color:#222222">Methods: </span></span></strong><span style="font-size:12.0pt"><span style="color:#222222">Case series of the first patients submitted to the Aveir implantation in two tertiary centers in Portugal. Clinical and procedure data were collected, and devices were interrogated immediately after implantation. Data from the initial corresponding Micra implantations were retrospectively gathered from each center. Statistical analysis was performed with SPSS.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="color:#222222">Results: </span></span></strong><span style="font-size:12.0pt"><span style="color:#222222">A total of 21 patients (mean age 76±13, 70% male) were included. Procedures were successful in 20 / 21 patients (95.2%) - one procedure was complicated with a cardiac tamponade after Aveir repositioning. Two patients performed AV nodal ablation simultaneously with leadless implantation. Indications and procedure related data is presented in table 1. The primary pacing indication was AV nodal disease (N = 18, 85,7%) in the majority of patients and similar between systems. In 11 patients a leadless system was preferred due to prior complications with pacing systems, chronic kidney failure in hemodialysis, absence of venous accesses or severe tricuspid regurgitation. The remainder presented permanent atrial fibrillation (N = 8, 28%) and in 1 a low percentage of pacing was expected. Comparison of device interrogation data reveals that all parameters presented similar values with the exception for longevity which was significantly higher with Aveir devices (p = 0.011).</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="color:#222222">Conclusion: </span></span></strong><span style="font-size:12.0pt"><span style="color:#222222">We present the first comparison between the two available leadless system devices regarding procedure success, complications and device parameters. One major complication was observed after one Aveir implantation. A significantly higher longevity is expected with Aveir system device in comparison to Micra transcatheter pacing system. Longterm </span></span></span></span></p> <div> </div> <p> </p>
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