Leadless pacemakers in critically ill patients requiring prolonged cardiac pacing: A multicenter international study - Archive ouverte HAL Access content directly
Journal Articles Journal of Cardiovascular Electrophysiology Year : 2021

Leadless pacemakers in critically ill patients requiring prolonged cardiac pacing: A multicenter international study

Abstract

Background Temporary transvenous pacing in critically ill patients requiring prolonged cardiac pacing is associated with a high risk of complications. We sought to evaluate the safety and efficacy of self-contained intracardiac leadless pacemaker (LPM) implantation in this population. Methods and Results Consecutive patients implanted with a Micra LPM during the hospitalization in an intensive care unit were retrospectively included. Inclusion criteria were: more than or equal to 1 supracaval central venous line, or a ventilation tube, or intravenous antibiotic therapy for ongoing sepsis or bacteremia. Patients with a history of the previous implantation of a pacemaker were excluded. Out of 1016 patients implanted with an LPM, 99 met the inclusion criteria. Mean age was 75 years and Charlson comorbidity index 7. LPM implantation was successfully performed in 98% of cases, with a perioperative complication rate of 5%, mainly cardiac injuries. In-hospital mortality rate was 6%. No late (>30 days) device-related complication occurred, especially no infection. Conclusions LPM appears as an acceptable alternative to conventional temporary transvenous pacing in selected critically ill patients requiring prolonged cardiac pacing, especially regarding the risk of infection.

Dates and versions

hal-03476854 , version 1 (13-12-2021)

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Nicolas Clementy, Roxane Coelho, Christian Veltmann, Eloi Marijon, Jose Tolosana, et al.. Leadless pacemakers in critically ill patients requiring prolonged cardiac pacing: A multicenter international study. Journal of Cardiovascular Electrophysiology, 2021, 32 (9), pp.2522-2527. ⟨10.1111/jce.15175⟩. ⟨hal-03476854⟩
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