Quality of life of patients undergoing conventional vs leadless pacemaker implantation: A multicenter observational study

Abstract

Background: Leadless pacemakers (L-PM) are an emerging effective and safe technology that offer an alternative to conventional pacemakers (C-PM) for right ventricular stimulation. However, there is little information about their potential benefits for quality of life (QoL) in patients with L-PM. We compared QoL between patients with L-PM and C-PM. Methods:The study population comprised patients undergoing single chamber pacemaker implantation from December 2016 to March 2018. The SF-36 questionnaire was used to evaluate QoL at baseline and at 6 months of followup.We also used a questionnaire consisted of 10 specific questions related to the implant procedure.Results: A total of 106 patients (64 C-PM; 42 L-PM) were included. There were no differences in baseline characteristics between the groups (C-PM vs L-PM), except for age (81.5 vs 77.3 years; P = .012) and diabetes (38% vs 17%; P = .021). Baseline SF-36 scores did not differ between the groups. At 6 months followup, patients in the L-PM group scored significantly higher on physical function (63 vs 42; P < .001), physical role (64 vs 36; P = .004), and mental health (75 vs 65; P = .017), even after adjusting for covariates. Pacemaker-related discomfort and physical restrictions were significantly lower for the L-PM group.

A leadless pacemaker matched with a vasovagal syncope: how long can it last?

“…Besides, previous studies showed that leadless pacing is associated with better quality of life than conventional pacing in both physical and mental health 10 . However, To date, there are no randomized controlled trials that compare efficacy and long‐term safety between transvenous and leadless pacemakers and further studies comparing both systems are needed.…”

“…8,9 In addition, it is also demonstrated that LPs are associated with better quality of life than TV-PPM. 10 At the end of battery life, a reasonable strategy might be to implant another LP without extracting the old one. There are concerns regard battery longevity specially with the paucity of data on device extraction and the number of concomitant LPs that can be implanted safely.…”

“…Studies on the use of LPs for cardioinhibitory vasovagal population specifically, concluded that the safety and efficacy of LPs are comparable with TV‐PPM 8,9 . In addition, it is also demonstrated that LPs are associated with better quality of life than TV‐PPM 10 …”

Tricuspid Valve Replacement in a Patient with a Leadless Cardiac Pacemaker: Current Guidelines and Recommendations for Perioperative Management

“…Even for complication-free transvenous pacemaker implants, it can be distressing for the patient to have a subcutaneous bulge, reminding them of their dependence on a pacemaker. Contrastingly, patients with LPs have been shown to have superior physical function, mental health, and significantly lower pacemaker-related discomfort [ 9 ]. Indications for leadless pacing include atrioventricular (AV) block with atrial fibrillation, bradycardia, and AV block or sinus node disease that does not require frequent ventricular pacing [ 1 , 10 ].…”

Leadless pacemaker implantation sites confirmed by computed tomography and their parameters and complication rates

“…Hence, the use of leadless pacemakers may be associated with a lower complication rate compared to conventional transvenous pacemakers 6,7 . The implantation procedure of leadless pacemakers is simpler and less invasive compared to conventional transvenous pacemakers, leading to a better quality of life 8 . However, the risk of cardiac tamponade has been reported more with leadless pacemaker use than that with conventional transvenous pacemaker use 9 .…”