Initial Experience With Leadless Cardiac Pacemakers at Auckland City Hospital

Abstract

Leadless cardiac pacemaker (LCP) therapy is a relatively new technology introduced to address lead-related and pocket-related complications seen with traditional transvenous and epicardial pacemakers. These differ from traditional pacemakers as they are much smaller and directly implanted into the right ventricle via percutaneous femoral approach. Ten patients underwent LCP implantation with a Medtronic Micra device over a 2-year period from 29 October 2020; four of these were Micra VR and six Micra AV. These patients were followed in clinic with device checks at a maximum of 6-monthly intervals. All 10 patients had a successful device implant procedure. Post-procedure follow-up data were available for all patients and ranged 5–24 months. Mean age was 63.7 years (range 52–81) and 70% were male. Procedure duration was 47.8±13.9 minutes, fluoroscopy time was 6.2±3.5 minutes, and contrast volume was 45±29.7 mL. There were no procedural or in-hospital procedure-related complications. Two deaths were recorded post implant, which were both unrelated to the LCP implant. The electronic pacing performance showed all capture thresholds remained at <1V @ 0.24 ms. Initial experience with a leadless cardiac pacemaker shows successful implantation, with no adverse events and satisfactory procedural data. Pacing performance post implant is stable with acceptable parameters and device function.