Patient selection, pacing indications, and subsequent outcomes with de novo leadless single-chamber VVI pacing.

Journal Article (Journal Article;Multicenter Study)

AIMS: Patient selection is a key component of securing optimal patient outcomes with leadless pacing. We sought to describe and compare patient characteristics and outcomes of Micra patients with and without a primary pacing indication associated with atrial fibrillation (AF) in the Micra IDE trial. METHODS AND RESULTS: The primary outcome (risk of cardiac failure, pacemaker syndrome, or syncope related to the Micra system or procedure) was compared between successfully implanted patients from the Micra IDE trial with a primary pacing indication associated with AF or history of AF (AF group) and those without (non-AF group). Among 720 patients successfully implanted with Micra, 228 (31.7%) were in the non-AF group. Reasons for selecting VVI pacing in non-AF patients included an expectation for infrequent pacing (66.2%) and advanced age (27.2%). More patients in the non-AF group had a condition that precluded the use of a transvenous pacemaker (9.6% vs. 4.7%, P = 0.013). Atrial fibrillation patients programmed to VVI received significantly more ventricular pacing compared to non-AF patients (median 67.8% vs. 12.6%; P < 0.001). The overall occurrence of the composite outcome at 24 months was 1.8% with no difference between the AF and non-AF groups (hazard ratio 1.36, 95% confidence interval 0.45-4.2; P = 0.59). CONCLUSION: Nearly one-third of patients selected to receive Micra VVI therapy were for indications not associated with AF. Non-AF VVI patients required less frequent pacing compared to patients with AF. Risks associated with VVI therapy were low and did not differ in those with and without AF.

Full Text

Duke Authors

Cited Authors

  • Piccini, JP; Stromberg, K; Jackson, KP; Kowal, RC; Duray, GZ; El-Chami, MF; Crossley, GH; Hummel, JD; Narasimhan, C; Omar, R; Ritter, P; Roberts, PR; Soejima, K; Reynolds, D; Zhang, S; Steinwender, C; Chinitz, L; Micra Transcatheter Pacing Study Group,

Published Date

  • November 1, 2019

Published In

Volume / Issue

  • 21 / 11

Start / End Page

  • 1686 - 1693

PubMed ID

  • 31681964

Electronic International Standard Serial Number (EISSN)

  • 1532-2092

Digital Object Identifier (DOI)

  • 10.1093/europace/euz230


  • eng

Conference Location

  • England