Leadless pacing in the elderly: never too old for something new

  • Valentina Barletta | valentinabarletta@hotmail.com Second Department of Cardiology, Cardiac Thoracic and Vascular Department, University Hospital of Pisa, Italy. https://orcid.org/0000-0002-4231-7781
  • Giulio Zucchelli Second Department of Cardiology, Cardiac Thoracic and Vascular Department, University Hospital of Pisa, Italy. https://orcid.org/0000-0001-7274-4541
  • Matteo Parollo Second Department of Cardiology, Cardiac Thoracic and Vascular Department, University Hospital of Pisa, Italy. https://orcid.org/0000-0001-9397-1938
  • Mario Giannotti Santoro Second Department of Cardiology, Cardiac Thoracic and Vascular Department, University Hospital of Pisa, Italy. https://orcid.org/0000-0001-5829-4919
  • Silvio Tolve Second Department of Cardiology, Cardiac Thoracic and Vascular Department, University Hospital of Pisa, Italy.
  • Andrea Di Cori Second Department of Cardiology, Cardiac Thoracic and Vascular Department, University Hospital of Pisa, Italy.
  • Luca Segreti Second Department of Cardiology, Cardiac Thoracic and Vascular Department, University Hospital of Pisa, Italy. https://orcid.org/0000-0002-1421-9033
  • Raffaele De Lucia Second Department of Cardiology, Cardiac Thoracic and Vascular Department, University Hospital of Pisa, Italy. https://orcid.org/0000-0001-8222-3977
  • Maria Grazia Bongiorni Second Department of Cardiology, Cardiac Thoracic and Vascular Department, University Hospital of Pisa, Italy.

Abstract

Rates of cardiac pacemaker implantation rise with age, and, meanwhile, elderly patient may be at great risk of complications, as pneumothorax, lead perforation, or pocket dehiscence. The use of leadless pacemaker could overcome peri- and post-procedural complications related to the presence of transvenous leads and pocket. The study aims to investigate feasibility and outcomes of Micra Transcatheter Pacing System (M-TPS) implantation in elderly, which represents a challenge for conventional cardiac pacing. Between May 2014 and July 2019, 109 patients (88 males, mean age 77.71±9.68 years) underwent M-TPS implantation at our Center, targeting a non-apical site of delivery when feasible. Study population was divided into two groups according to age (group 1 <79 years vs group 2 group 2 ≥80 years). The outcome evaluation included electrical performance at hospital discharge, and during follow-up. In 46/109 cases (34 males, 73.91%) M-TPS was implanted in patients older than 80 years. There were no statistically significant differences between groups for demographics characteristics, except for age. The procedure was performed via the right femoral access in 102/109 cases and was successful in all cases, with no device-related events. No differences were observed between groups in procedure duration, single device delivery, electrical performance at implant and at 12 month F-U. MTP-S implant is an effective and safe procedure in elderly patients, with similar electrical performance and outcome compared with younger patients at mid-term follow-up.

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Published
2020-11-20
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Section
Cardiology - Reviews
Keywords:
Leadless pacemaker, lead extraction, Micra, cardiac pacing, elderly
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How to Cite
Barletta, V., Zucchelli, G., Parollo, M., Giannotti Santoro, M., Tolve, S., Di Cori, A., Segreti, L., De Lucia, R., & Bongiorni, M. G. (2020). Leadless pacing in the elderly: never too old for something new. Monaldi Archives for Chest Disease, 90(4). https://doi.org/10.4081/monaldi.2020.1255