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Leadless Pacemaker Implantation in the Emergency Bradyarrhythmia Setting: Results from a Multicenter European Registry

Background. Data on leadless pacemaker (LPM) implantation in an emergency setting are currently lacking. Objective. We aimed to investigate the feasibility of LPM implantation for emergency bradyarrhythmia, in patients referred for urgent PM implantation, in a large, multicenter, real-world cohort o...

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Autores principales: Schiavone, Marco, Filtz, Annalisa, Gasperetti, Alessio, Breitenstein, Alexander, Palmisano, Pietro, Mitacchione, Gianfranco, Gulletta, Simone, Chierchia, Gian Battista, Montemerlo, Elisabetta, Statuto, Giovanni, Russo, Giulia, Casella, Michela, Vitali, Francesco, Mazzone, Patrizio, Hofer, Daniel, Arabia, Gianmarco, Tundo, Fabrizio, Ruggiero, Diego, Fierro, Nicolai, Moltrasio, Massimo, Bertini, Matteo, Dello Russo, Antonio, Pisanò, Ennio C. L., Della Bella, Paolo, Rovaris, Giovanni, de Asmundis, Carlo, Biffi, Mauro, Curnis, Antonio, Tondo, Claudio, Saguner, Ardan M., Forleo, Giovanni B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9861740/
https://www.ncbi.nlm.nih.gov/pubmed/36676690
http://dx.doi.org/10.3390/medicina59010067
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author Schiavone, Marco
Filtz, Annalisa
Gasperetti, Alessio
Breitenstein, Alexander
Palmisano, Pietro
Mitacchione, Gianfranco
Gulletta, Simone
Chierchia, Gian Battista
Montemerlo, Elisabetta
Statuto, Giovanni
Russo, Giulia
Casella, Michela
Vitali, Francesco
Mazzone, Patrizio
Hofer, Daniel
Arabia, Gianmarco
Tundo, Fabrizio
Ruggiero, Diego
Fierro, Nicolai
Moltrasio, Massimo
Bertini, Matteo
Dello Russo, Antonio
Pisanò, Ennio C. L.
Della Bella, Paolo
Rovaris, Giovanni
de Asmundis, Carlo
Biffi, Mauro
Curnis, Antonio
Tondo, Claudio
Saguner, Ardan M.
Forleo, Giovanni B.
author_facet Schiavone, Marco
Filtz, Annalisa
Gasperetti, Alessio
Breitenstein, Alexander
Palmisano, Pietro
Mitacchione, Gianfranco
Gulletta, Simone
Chierchia, Gian Battista
Montemerlo, Elisabetta
Statuto, Giovanni
Russo, Giulia
Casella, Michela
Vitali, Francesco
Mazzone, Patrizio
Hofer, Daniel
Arabia, Gianmarco
Tundo, Fabrizio
Ruggiero, Diego
Fierro, Nicolai
Moltrasio, Massimo
Bertini, Matteo
Dello Russo, Antonio
Pisanò, Ennio C. L.
Della Bella, Paolo
Rovaris, Giovanni
de Asmundis, Carlo
Biffi, Mauro
Curnis, Antonio
Tondo, Claudio
Saguner, Ardan M.
Forleo, Giovanni B.
author_sort Schiavone, Marco
collection PubMed
description Background. Data on leadless pacemaker (LPM) implantation in an emergency setting are currently lacking. Objective. We aimed to investigate the feasibility of LPM implantation for emergency bradyarrhythmia, in patients referred for urgent PM implantation, in a large, multicenter, real-world cohort of LPM recipients. Methods. Two cohorts of LPM patients, stratified according to the LPM implantation scenario (patients admitted from the emergency department (ED+) vs. elective patients (ED−)) were retrieved from the iLEAPER registry. The primary outcome of the study was a comparison of the peri-procedural complications between the groups. The rates of peri-procedural characteristics (overall procedural and fluoroscopic duration) were deemed secondary outcomes. Results. A total of 1154 patients were enrolled in this project, with patients implanted due to an urgent bradyarrhythmia (ED+) representing 6.2% of the entire cohort. Slow atrial fibrillation and complete + advanced atrioventricular blocks were more frequent in the ED+ cohort (76.3% for ED+ vs. 49.7% for ED−, p = 0.025; 37.5% vs. 27.3%, p = 0.027, respectively). The overall procedural times were longer in the ED+ cohort (60 (45–80) mins vs. 50 (40–65) mins, p < 0.001), showing higher rates of temporary pacing (94.4% for ED+ vs. 28.9% for ED−, p < 0.001). Emergency LPM implantation was not correlated with an increase in the rate of major complications compared to the control group (6.9% ED+ vs. 4.2% ED−, p = 0.244). Conclusion. LPM implantation is a feasible procedure for the treatment of severe bradyarrhythmia in an urgent setting. Urgent LPM implantation was not correlated with an increase in the rate of major complications compared to the control group, but it was associated with longer procedural times.
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spelling pubmed-98617402023-01-22 Leadless Pacemaker Implantation in the Emergency Bradyarrhythmia Setting: Results from a Multicenter European Registry Schiavone, Marco Filtz, Annalisa Gasperetti, Alessio Breitenstein, Alexander Palmisano, Pietro Mitacchione, Gianfranco Gulletta, Simone Chierchia, Gian Battista Montemerlo, Elisabetta Statuto, Giovanni Russo, Giulia Casella, Michela Vitali, Francesco Mazzone, Patrizio Hofer, Daniel Arabia, Gianmarco Tundo, Fabrizio Ruggiero, Diego Fierro, Nicolai Moltrasio, Massimo Bertini, Matteo Dello Russo, Antonio Pisanò, Ennio C. L. Della Bella, Paolo Rovaris, Giovanni de Asmundis, Carlo Biffi, Mauro Curnis, Antonio Tondo, Claudio Saguner, Ardan M. Forleo, Giovanni B. Medicina (Kaunas) Article Background. Data on leadless pacemaker (LPM) implantation in an emergency setting are currently lacking. Objective. We aimed to investigate the feasibility of LPM implantation for emergency bradyarrhythmia, in patients referred for urgent PM implantation, in a large, multicenter, real-world cohort of LPM recipients. Methods. Two cohorts of LPM patients, stratified according to the LPM implantation scenario (patients admitted from the emergency department (ED+) vs. elective patients (ED−)) were retrieved from the iLEAPER registry. The primary outcome of the study was a comparison of the peri-procedural complications between the groups. The rates of peri-procedural characteristics (overall procedural and fluoroscopic duration) were deemed secondary outcomes. Results. A total of 1154 patients were enrolled in this project, with patients implanted due to an urgent bradyarrhythmia (ED+) representing 6.2% of the entire cohort. Slow atrial fibrillation and complete + advanced atrioventricular blocks were more frequent in the ED+ cohort (76.3% for ED+ vs. 49.7% for ED−, p = 0.025; 37.5% vs. 27.3%, p = 0.027, respectively). The overall procedural times were longer in the ED+ cohort (60 (45–80) mins vs. 50 (40–65) mins, p < 0.001), showing higher rates of temporary pacing (94.4% for ED+ vs. 28.9% for ED−, p < 0.001). Emergency LPM implantation was not correlated with an increase in the rate of major complications compared to the control group (6.9% ED+ vs. 4.2% ED−, p = 0.244). Conclusion. LPM implantation is a feasible procedure for the treatment of severe bradyarrhythmia in an urgent setting. Urgent LPM implantation was not correlated with an increase in the rate of major complications compared to the control group, but it was associated with longer procedural times. MDPI 2022-12-28 /pmc/articles/PMC9861740/ /pubmed/36676690 http://dx.doi.org/10.3390/medicina59010067 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Schiavone, Marco
Filtz, Annalisa
Gasperetti, Alessio
Breitenstein, Alexander
Palmisano, Pietro
Mitacchione, Gianfranco
Gulletta, Simone
Chierchia, Gian Battista
Montemerlo, Elisabetta
Statuto, Giovanni
Russo, Giulia
Casella, Michela
Vitali, Francesco
Mazzone, Patrizio
Hofer, Daniel
Arabia, Gianmarco
Tundo, Fabrizio
Ruggiero, Diego
Fierro, Nicolai
Moltrasio, Massimo
Bertini, Matteo
Dello Russo, Antonio
Pisanò, Ennio C. L.
Della Bella, Paolo
Rovaris, Giovanni
de Asmundis, Carlo
Biffi, Mauro
Curnis, Antonio
Tondo, Claudio
Saguner, Ardan M.
Forleo, Giovanni B.
Leadless Pacemaker Implantation in the Emergency Bradyarrhythmia Setting: Results from a Multicenter European Registry
title Leadless Pacemaker Implantation in the Emergency Bradyarrhythmia Setting: Results from a Multicenter European Registry
title_full Leadless Pacemaker Implantation in the Emergency Bradyarrhythmia Setting: Results from a Multicenter European Registry
title_fullStr Leadless Pacemaker Implantation in the Emergency Bradyarrhythmia Setting: Results from a Multicenter European Registry
title_full_unstemmed Leadless Pacemaker Implantation in the Emergency Bradyarrhythmia Setting: Results from a Multicenter European Registry
title_short Leadless Pacemaker Implantation in the Emergency Bradyarrhythmia Setting: Results from a Multicenter European Registry
title_sort leadless pacemaker implantation in the emergency bradyarrhythmia setting: results from a multicenter european registry
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9861740/
https://www.ncbi.nlm.nih.gov/pubmed/36676690
http://dx.doi.org/10.3390/medicina59010067
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