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].