ABSTRACT
Background: Temporary transvenous pacing in critically ill
patients requiring prolonged cardiac pacing is associated with a high
risk of complications. We sought to evaluate the safety and efficacy of
self-contained intracardiac leadless pacemaker (LPM) implantation in
this population.
Methods and Results: Consecutive patients implanted with a
Micra LPM during the hospitalization in an intensive care unit were
retrospectively included. Inclusion criteria were: ≥1 supracaval central
venous, or a ventilation tube, or intravenous antibiotic therapy for
ongoing sepsis or bacteremia. Patients with a history of previous
implantation of a pacemaker were excluded. Out of 1,016 patients
implanted with an LPM, 99 met the inclusion criteria. Mean age was 75
years and Charlson comorbidity index 7. LPM implantation was
successfully performed in 98% of cases, with a peri-operative
complication rate of 5%, mainly cardiac injuries. In-hospital mortality
rate was 6%. No late (>30 days) device-related
complication occurred, especially no infection.
Conclusions: LPM appears as an acceptable alternative to
conventional temporary transvenous pacing in selected critically ill
patients requiring prolonged cardiac pacing, especially regarding the
risk of infection.