Temporal Trends and In-Hosptial Outcomes of Leadless Pacemakers in Transcatheter Aortic Valve Replacement Patients: A 5-Year Nationwide Patient Sample Analysis

Document Type

Article

Abstract

Background: There is limited data on use of leadless pacemaker devices (L-PPM) in patients with Transcatheter Aortic Valve Replacement (TAVR) as compared to use of conventional transvenous pacemakers (C-PPM).

Methods: National Inpatient Sample 2016-2020 was used to identify TAVR cases and these were further grouped into L-PPM and C-PPM using appropriate diagnostic and procedural codes. Temporal trends and in-hospital outcomes were obtained.

Results: From 2016 to 2020, use of L-PPM devices increased by roughly 15 times in TAVR cases (Table). A significant proportion of L-PPM devices were deployed in the southern and western US with 94% of these procedures performed at urban, teaching hospitals. This group also had higher length of stay (LOS) and total hospital cost as compared to C-PPM (7.3-vs-5.8 days and $349,560-vs-$278,465 respectively). Mortality was higher in females in both groups with even higher mortality in females in L-PPM group. L-PPM group were more likely to have a higher Charlson comorbidity index (61.5%-vs-57.9%, p=0.04) and higher rates of acute kidney injury, admission to ICU and need for hemodialysis.

Conclusion: There has been a significant increase in use of leadless PPM devices across the US in TAVR cases. The increased mortality in this group is likely associated with higher burden of comorbidities.

First Page

164

DOI

10.1016/S0735-1097(24)02154-5

Publication Date

4-2-2024

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