Outcomes of Micra Leadless Pacemaker Implants in Centers With and Without Cardiac Surgery.

Abstract

Background: Micra leadless pacemaker offers an alternative to traditional transvenous pacemakers by eliminating the risks associated with leads and device pockets. Due to the technical demands of a leadless transcatheter pacemaker, concerns initially limited the procedure to centers with on-site cardiac surgery (CS) capabilities. However, growing evidence supports its safe implementation in noncardiac surgical centers, though data comparing outcomes in these settings remain limited.

Aims: This analysis aims to evaluate the safety and feasibility of Micra leadless pacemaker implantation in centers with and without CS, assessing acute complications, device performance, and patient follow-up.

Methods: A retrospective analysis was conducted on 1899 patients who received a Micra pacemaker from May 2015 to September 2024 at 23 centers. Patients were divided into two groups: those implanted in centers with CS (CS, n = 1025) and those without (No-CS, n = 874). The primary endpoint was acute complications within 15 days postimplant, while secondary endpoints included device performance and clinical follow-up at 12 months.

Results: The overall acute complication rate was low at 0.6%, with no significant difference between the CS (0.5%) and No-CS groups (0.8%; p = 0.391). Procedural times were slightly shorter in No-CS centers (41.2 ± 19.8 vs. 46.1 ± 19.3 min; p < 0.001), and both groups showed comparable device performance and patient outcomes over the follow-up period.

Conclusion: The Micra leadless pacemaker can be safely and effectively implanted in centers without CS capabilities, broadening access to this technology across diverse clinical settings.