Abstract 12623: Leadless Pacemaker Insertion is Safe in Pulmonary Hypertension Patients

Abstract

Introduction: Compared to conventional single-chamber pacemakers, leadless pacemakers (LPM) had a higher risk of pericardial effusion and/or perforation, but decreased risk of other delayed device related complications. Pulmonary hypertension patients often have higher pressures in the adjacent right ventricle, possibly increasing the risk of perforation and pericardial complications. Methods: The National Readmission Database years 2017 to 2020 were queried for the patients who underwent LPM placement with the ICD10 code (02HK3NZ). Patient comorbidities were identified using the appropriate ICD10 codes. Multivariate logistic regression was used to compare outcomes in patients with and without pulmonary hypertension, adjusting for patient comorbidities shown in Table 1. Results: We identified 26,084 patients who underwent LPM placement, 4114 (15.77%) of whom had pulmonary hypertension. There was no statistically significant difference in the primary outcomes of 30-day readmission (aOR 1.01, p 0.37, 95% CI 0.936 - 1.193), or mortality (aOR 0.973, p 0.82, 95% CI 0.769 - 1.232). There was no difference in the composite outcome of pericardial complications (aOR 0.729, p 0.17, 95% CI 0.462 - 1.149) which included hemopericardium, tamponade, or the need for pericardiocentesis. However, patients with pulmonary hypertension had a higher risk of postprocedure bleed (aOR 1.182, p 0.036), hemothorax (aOR 2.493, p 0.003), and cardiogenic shock (aOR 2.447, p<0.001). Rest of the outcomes shown in Table 2. Conclusions: Leadless pacemaker insertion appears to be safe in pulmonary hypertension patients, although patients seem to be at increased risk for bleeding complications.