Leadless or Conventional Transvenous Ventricular Permanent Pacemakers: A Nationwide Matched Control Study.



Bodin, Alexandre ORCID: 0000-0002-6544-3916, Clementy, Nicolas, Bisson, Arnaud ORCID: 0000-0002-3449-1800, Pierre, Bertrand, Herbert, Julien, Babuty, Dominique and Fauchier, Laurent ORCID: 0000-0002-9267-1658
(2022) Leadless or Conventional Transvenous Ventricular Permanent Pacemakers: A Nationwide Matched Control Study. Journal of the American Heart Association, 11 (16). e025339-.

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Abstract

Background Leadless ventricular permanent pacemakers (leadless VVI or LPM) were designed to reduce lead-related complications of conventional VVI pacemakers (CPM). The aim of our study was to assess and compare real-life clinical outcomes within the first 30 days and during a midterm follow-up with the 2 techniques. Methods and Results This French longitudinal cohort study was based on the national hospitalization database. All adults (age ≥18 years) hospitalized in French hospitals from January 1, 2017 to September 1, 2020, who underwent a first LPM or CPM were included. The study included 40 828 patients with CPM and 1487 with LPM. After propensity score matching 1344 patients with CPM were matched 1:1 with patients treated with LPM. Patients with LPM had a lower rate of all-cause and cardiovascular death within the 30 days after implantation. During subsequent follow-up (mean: 8.6±10.5 months), risk of all-cause death in the unmatched population was significantly higher in the LPM group than in the CPM group, whereas risk of cardiovascular death and of endocarditis was not significantly different. After matching on all baseline characteristics including comorbidities (mean follow-up 6.2±8.7 months), all-cause death, cardiovascular death, and infective endocarditis were not statistically different in the 2 groups. Conclusions Patients treated with leadless VVI pacemakers had better clinical outcomes in the first month compared with the patients treated with conventional VVI pacing. During a midterm follow-up, risk of all-cause death, cardiovascular death, and endocarditis in patients treated with leadless VVI pacemaker was not statistically different after propensity score matching.

Item Type: Article
Uncontrolled Keywords: Heart Ventricles, Humans, Treatment Outcome, Cardiac Pacing, Artificial, Longitudinal Studies, Equipment Design, Pacemaker, Artificial, Adolescent, Arrhythmias, Cardiac
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User: Symplectic Admin
Date Deposited: 24 Jan 2023 09:29
Last Modified: 24 Jan 2023 09:29
DOI: 10.1161/jaha.122.025339
Open Access URL: https://doi.org/10.1161/JAHA.122.025339
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3167835