Limitations
Although this multicenter European registry included most of the main LPM implanting centers, it may not reflect the general population requiring permanent pacing in ICU. LPM, which is not to be removed, is a permanent device, whereas TTP is only followed by PPM implantation in roughly 2 thirds of cases [2]. This technique also raises the question about the overall procedure cost. Finally, all LPMs implanted in this study were single-chamber device, even in sinus rhythm patients with complete atrioventricular block. The next generation of LPM with atrioventricular synchronization should solve this potential issue [21].