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Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2017;70:275-81 - Vol. 70 Num.04 DOI: 10.1016/j.rec.2016.11.027

The Micra Leadless Transcatheter Pacemaker. Implantation and Mid-term Follow-up Results in a Single Center

José Luis Martínez-Sande a,, Javier García-Seara a, Moisés Rodríguez-Mañero a, Xesús Alberte Fernández-López a, Laila González-Melchor a, Alfredo Redondo-Diéguez a, Rocío González-Ferreiro a, José Ramón González-Juanatey a

a Unidad de Arritmias y Electrofisiología Cardiaca, Servicio de Cardiología y Unidad Coronaria, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain

Keywords

Leadless pacemaker. Cardiac pacing. Atrial fibrillation.

Abstract

Introduction and objectives

Currently, studies on the leadless pacemaker (Micra) have mostly been limited to clinical trials with less than 6 months’ follow-up and they often fail to reflect real population outcomes. We sought to evaluate electrical parameters at implantation and chronologically during follow-up, as well as the safety of this new technique.

Methods

This prospective, observational study included 30 consecutive patients, all ≥ 65 years, with an indication for single-chamber pacemaker implantation.

Results

Successful implantation was accomplished in all patients referred for leadless implantation. The mean age was 79.4 ± 6.4 years (range, 66-89 years); 20 (66.6%) were men and 28 had permanent atrial fibrillation (93.3%); 1 had atrial tachycardia and 1 had sinus rhythm. Concomitant atrioventricular node ablation was performed immediately after implantation in 5 patients (16.6%), and implantation was performed after transcatheter aortic valve implantation in 2. The procedure was performed under an uninterrupted anticoagulation regimen (maximum INR 2.4) in 23 patients (76.6%). With the exception of 1 moderate pericardial effusion without tamponade, there were no severe complications. The mean follow-up was 5.3 ± 3.3 months and 4 patients had more than 1 year of follow-up. Sensing and pacing parameters were stable both at implantation and during the short- to mid-term follow-up.

Conclusions

Implantation of leadless pacemakers is feasible, safe and provides advantages over the conventional system. Further studies with longer follow-up periods will be needed before these devices become widely used in routine clinical practice.

1885-5857/© 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved