B-PO03-041 CORRELATION OF EF AND >99% PACING IN PATIENTS WITH LEADLESS PACEMAKERS

Abstract

Pacemaker induced cardiomyopathy is a known complication of frequent RV pacing with transvenous pacemakers. A strategy of atrioventricular node ablation with implantation of a leadless pacemaker has become a popular rate control strategy in the elderly population with permanent atrial fibrillation. However, the incidence of pacemaker induced cardiomyopathy is not known in this population. To describe the incidence of pacemaker induced cardiomyopathy as defined by ≥ 10% LVEF drop in patients with >99% RV pacing through a leadless pacemaker. This was a single center, retrospective study of patients who received a leadless pacemaker between 2015 and 2020. Patients with >99% pacing and 2 years of echocardiogram data were included in the final analysis. A total of 122 patients with leadless pacemakers were identified. After excluding patients who were paced <99% of the time and those without sufficient echocardiogram or interrogation data, 39 patients were included in the final analysis. The median RV pacing frequency was 99.7% with the median time to last EF being 236 days post implantation. The mean EF pre-implantation was 61% and mean EF post-implant was 59%. The mean change in EF of 2.8% was not statistically significant (p = 0.09). In patients who undergo leadless permanent pacemaker implantation and AV node ablation, permanent pacing was not associated with a significant drop in ejection fraction after 2 years.