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Zucchelli G, Tolve S, Barletta V, Di Cori A, Parollo M, De Lucia R, Della Tommasina V, Giannotti Santoro M, Viani S, Cellamaro T, Segreti L, Paperini L, Soldati E, Bongiorni MG. Comparison between leadless and transvenous single-chamber pacemaker therapy in a referral centre for lead extraction. J Interv Card Electrophysiol 2020; 61:395-404. [DOI: 10.1007/s10840-020-00832-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 07/17/2020] [Indexed: 01/28/2023]
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Zucchelli G, Barletta V, Della Tommasina V, Viani S, Parollo M, Mazzocchetti L, Cellamaro T, Paperini L, Di Cori A, De Lucia R, Segreti L, Soldati E, Bongiorni MG. Micra pacemaker implant after cardiac implantable electronic device extraction: feasibility and long-term outcomes. Europace 2019; 21:1229-1236. [DOI: 10.1093/europace/euz160] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 05/14/2019] [Indexed: 11/13/2022] Open
Abstract
Abstract
Aims
We aimed at investigating the feasibility and outcome of Micra implant in patients who have previously undergone transvenous lead extraction (TLE), in comparison to naïve patients implanted with the same device.
Methods and results
Eighty-three patients (65 males, 78.31%; 77.27 ± 9.96 years) underwent Micra implant at our centre. The entire cohort was divided between ‘post-extraction’ (Group 1) and naïve patients (Group 2). In 23 of 83 patients (20 males, 86.96%; 73.83 ± 10.29 years), Micra was implanted after TLE. Indication to TLE was an infection in 15 patients (65.21%), leads malfunction in four (17.39%), superior vena cava syndrome in three (13.05%), and severe tricuspid regurgitation in one case (4.35%). The implant procedure was successful in all patients and no device-related events occurred at follow-up (median: 18 months; interquartile range: 1–24). No differences were observed between groups in fluoroscopy time (13.88 ± 10.98 min vs. 13.15 ± 6.64 min, P = 0.45), single device delivery (Group 1 vs. Group 2: 69.56% vs. 55%, P = 0.22), electrical performance at implant and at 12-month follow-up (Group 1 vs. Group 2: pacing threshold 0.48 ± 0.05 V/0.24 ms vs. 0.56 ± 0.25 V/0.24 ms, P = 0.70; impedance 640 ± 148.83 Ohm vs. 583.43 ± 99.7 Ohm, P = 0.27; and R wave amplitude 10.33 ± 2.88 mV vs. 12.62 ± 5.31 mV, P = 0.40). A non-apical site of implant was achievable in the majority of cases (72.3%) without differences among groups (78.26% vs. 70%; P = 0.42).
Conclusion
Micra implant is an effective and safe procedure in patients still requiring a ventricular pacing after TLE, with similar electrical performance and outcome compared with naïve patients at long-term follow-up.
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Affiliation(s)
- Giulio Zucchelli
- Second Department of Cardiology, Cardiothoracic and Vascular Department – University Hospital of Pisa, Via Paradisa, 2, Pisa, Italy
| | - Valentina Barletta
- Second Department of Cardiology, Cardiothoracic and Vascular Department – University Hospital of Pisa, Via Paradisa, 2, Pisa, Italy
| | - Veronica Della Tommasina
- Second Department of Cardiology, Cardiothoracic and Vascular Department – University Hospital of Pisa, Via Paradisa, 2, Pisa, Italy
| | - Stefano Viani
- Second Department of Cardiology, Cardiothoracic and Vascular Department – University Hospital of Pisa, Via Paradisa, 2, Pisa, Italy
| | - Matteo Parollo
- Second Department of Cardiology, Cardiothoracic and Vascular Department – University Hospital of Pisa, Via Paradisa, 2, Pisa, Italy
| | - Lorenzo Mazzocchetti
- Second Department of Cardiology, Cardiothoracic and Vascular Department – University Hospital of Pisa, Via Paradisa, 2, Pisa, Italy
| | - Tea Cellamaro
- Second Department of Cardiology, Cardiothoracic and Vascular Department – University Hospital of Pisa, Via Paradisa, 2, Pisa, Italy
| | - Luca Paperini
- Second Department of Cardiology, Cardiothoracic and Vascular Department – University Hospital of Pisa, Via Paradisa, 2, Pisa, Italy
| | - Andrea Di Cori
- Second Department of Cardiology, Cardiothoracic and Vascular Department – University Hospital of Pisa, Via Paradisa, 2, Pisa, Italy
| | - Raffaele De Lucia
- Second Department of Cardiology, Cardiothoracic and Vascular Department – University Hospital of Pisa, Via Paradisa, 2, Pisa, Italy
| | - Luca Segreti
- Second Department of Cardiology, Cardiothoracic and Vascular Department – University Hospital of Pisa, Via Paradisa, 2, Pisa, Italy
| | - Ezio Soldati
- Second Department of Cardiology, Cardiothoracic and Vascular Department – University Hospital of Pisa, Via Paradisa, 2, Pisa, Italy
| | - Maria Grazia Bongiorni
- Second Department of Cardiology, Cardiothoracic and Vascular Department – University Hospital of Pisa, Via Paradisa, 2, Pisa, Italy
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