Leadless pacemaker for patients following cardiac valve intervention.
Aged
Aged, 80 and over
Arrhythmias, Cardiac
/ diagnosis
Cardiac Pacing, Artificial
/ adverse effects
Cardiac Valve Annuloplasty
/ adverse effects
Female
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation
/ adverse effects
Heart Valves
/ diagnostic imaging
Humans
Male
Pacemaker, Artificial
Prospective Studies
Prosthesis Design
Transcatheter Aortic Valve Replacement
Treatment Outcome
Chirurgie valvulaire ;TAVI
Leadless pacing
Micra™
Stimulateur cardiaque sans sonde
TAVI
Valve surgery
Journal
Archives of cardiovascular diseases
ISSN: 1875-2128
Titre abrégé: Arch Cardiovasc Dis
Pays: Netherlands
ID NLM: 101465655
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
received:
11
02
2020
revised:
31
03
2020
accepted:
14
05
2020
pubmed:
7
9
2020
medline:
20
1
2021
entrez:
6
9
2020
Statut:
ppublish
Résumé
Permanent pacing is common after valve intervention. The presence of a conventional pacemaker in this population is recognized as a risk factor for infectious events. Therefore, a leadless pacing system could be the preferred strategy when permanent pacing is required after valve intervention. To report periprocedural outcomes and follow-up of patients undergoing implantation of a leadless pacing system after valve intervention. Patients with previous valve intervention at the time of attempted implantation of a leadless pacemaker (Micra™, Medtronic, Minneapolis, MN, USA) were included, and were compared with a control group (patients also implanted with Micra™ without valve intervention). Among a total of 170 Micra™ implantation procedures, 54 patients (31.8%) had a history of valve intervention: 28 after aortic valve replacement; 10 after mitral valve replacement; one after single tricuspid valvuloplasty; and 15 after multiple valve surgery. Median age of the patients was 82.5 (77.0-86.0) years and 53.7% were male. Patients with previous valve intervention had a higher incidence of arterial hypertension (P=0.014) and ischaemic heart disease (P=0.040). The primary indications for permanent pacing after valve intervention were high-degree atrioventricular block (59.3%) and atrial fibrillation with bradycardia (27.8%). Micra™ was successfully implanted in all patients (n=170) without any procedure-related major complications. During a median follow-up of 12 months, electrical performance was excellent and similar in both groups. Also, a similar reduction in left ventricular ejection fraction was observed at 12 months in both groups, which was correlated with the percentage of right ventricular pacing. A leadless pacemaker is safe and efficient after valve intervention, and therefore represents an effective pacing option in patients after valve intervention.
Sections du résumé
BACKGROUND
BACKGROUND
Permanent pacing is common after valve intervention. The presence of a conventional pacemaker in this population is recognized as a risk factor for infectious events. Therefore, a leadless pacing system could be the preferred strategy when permanent pacing is required after valve intervention.
AIM
OBJECTIVE
To report periprocedural outcomes and follow-up of patients undergoing implantation of a leadless pacing system after valve intervention.
METHODS
METHODS
Patients with previous valve intervention at the time of attempted implantation of a leadless pacemaker (Micra™, Medtronic, Minneapolis, MN, USA) were included, and were compared with a control group (patients also implanted with Micra™ without valve intervention).
RESULTS
RESULTS
Among a total of 170 Micra™ implantation procedures, 54 patients (31.8%) had a history of valve intervention: 28 after aortic valve replacement; 10 after mitral valve replacement; one after single tricuspid valvuloplasty; and 15 after multiple valve surgery. Median age of the patients was 82.5 (77.0-86.0) years and 53.7% were male. Patients with previous valve intervention had a higher incidence of arterial hypertension (P=0.014) and ischaemic heart disease (P=0.040). The primary indications for permanent pacing after valve intervention were high-degree atrioventricular block (59.3%) and atrial fibrillation with bradycardia (27.8%). Micra™ was successfully implanted in all patients (n=170) without any procedure-related major complications. During a median follow-up of 12 months, electrical performance was excellent and similar in both groups. Also, a similar reduction in left ventricular ejection fraction was observed at 12 months in both groups, which was correlated with the percentage of right ventricular pacing.
CONCLUSION
CONCLUSIONS
A leadless pacemaker is safe and efficient after valve intervention, and therefore represents an effective pacing option in patients after valve intervention.
Identifiants
pubmed: 32891563
pii: S1875-2136(20)30164-9
doi: 10.1016/j.acvd.2020.05.012
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
772-779Informations de copyright
Copyright © 2020 Elsevier Masson SAS. All rights reserved.